SHANA A BERGER (Credential# 1222293) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
SHANA A BERGER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0057169. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is Whiting Forensic Hospital, Middletown, CT 06457. The current status is active.
Licensee Name | SHANA A BERGER |
Credential ID | 1222293 |
Credential Number | CSP.0057169 |
Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
Business Address |
Whiting Forensic Hospital Middletown CT 06457 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2014-05-14 |
Effective Date | 2019-03-01 |
Expiration Date | 2021-02-28 |
Refresh Date | 2019-01-03 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1209839 | 1.053043 | Physician/Surgeon | 2014-05-09 | 2019-12-01 - 2020-11-30 | ACTIVE |
Street Address | WHITING FORENSIC HOSPITAL |
City | MIDDLETOWN |
State | CT |
Zip Code | 06457 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Sarah J Jacob | Whiting Forensic Hospital, Middletown, CT 06457 | Licensed Clinical Social Worker | 2019-11-01 ~ 2020-10-31 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Elizabeth M Mailhot | 177 Timber Ridge Rd, Middletown, CT 06457 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
Rebecca S Fennessy | 22 Keefe Ln, Middletown, CT 06457 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
Eloise M Gagnon | 538 Bow Lane, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
Salvatore Dimauro | 245 Dekoven Dr, Middletown, CT 06457 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
Frank L Wright | 261 Spencer Dr, Middletown, CT 06457 | Barber | 2020-08-01 ~ 2022-07-31 |
Gino A Cardella | 50 Sonoma Lane, Middletown, CT 06457 | Real Estate Salesperson | ~ |
Shannon Lee Mcquillan | 5 Forest Glen Circle, Middletown, CT 06457 | Registered Nurse | 2020-06-26 ~ 2020-09-30 |
Lori Dimauro · Carta | 244 Chamberlain Hill Road, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
Gail A Corrow | 85 Dora Dr, Middletown, CT 06457 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Mariter V Perez | 8 Moss Glen, Middletown, CT 06457 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
Find all Licenses in zip 06457 |
City | MIDDLETOWN |
Zip Code | 06457 |
License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MIDDLETOWN |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Erin Shana Valenti | 104 Nobscot Dr, Framingham, MA 01701-4082 | Controlled Substance Registration for Practitioner | 2020-04-06 ~ 2021-02-28 |
Antoni Berger Md | 211 New Britain Rd Ste 104, Berlin, CT 06037-3167 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Eric H Berger Md | 121 Whitney Ave Ste 420, New Haven, CT 06510-1242 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Michael Berger Md | 62 Sumner Rd, Greenwich, CT 06831 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
Bethanie Shana Berson | 2601 Ocean Pkwy, Brooklyn, NY 11235-7745 | Controlled Substance Registration for Practitioner | 2018-06-11 ~ 2019-02-28 |
Jeremy Joseph Berger | 714 Craigville Rd, Chester, NY 10918-4014 | Controlled Substance Registration for Practitioner | 2019-11-04 ~ 2021-02-28 |
Ann M Cohen-berger | 52 Miamis Rd, West Hartford, CT 06117 | Controlled Substance Registration for Practitioner | 1995-08-18 ~ 1996-02-28 |
Terri Erwin Md | 15 Berger Place, Branford, CT 06405 | Controlled Substance Registration for Practitioner | 2003-03-03 ~ 2004-02-28 |
Steven T Berger Md | 275 Bicentennial Highway, Springfield, MA 01118 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
Alan Berger Md | 19 Harbour Close, New Haven, CT 06519 | Controlled Substance Registration for Practitioner | 2000-02-29 ~ 2001-02-28 |
Please comment or provide details below to improve the information on SHANA A BERGER.
Data Provider | Connecticut Department of Consumer Protection |
Jurisdiction | Connecticut |
Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).