SANDIE JEAN DERIVAL (Credential# 1233169) is licensed (Advanced Practice Registered Nurse) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
SANDIE JEAN DERIVAL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #12.005821. The credential type is advanced practice registered nurse. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 79 River Bend Rd Unit D, Stratford, CT 06614-8090. The current status is active.
| Licensee Name | SANDIE JEAN DERIVAL |
| Credential ID | 1233169 |
| Credential Number | 12.005821 |
| Credential Type | Advanced Practice Registered Nurse |
| Business Address |
79 River Bend Rd Unit D Stratford CT 06614-8090 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2014-08-01 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-04-09 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 589512 | 10.085510 | Registered Nurse | 2008-07-11 | 2020-05-01 - 2021-04-30 | ACTIVE |
| 1239516 | CSP.0058474 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2014-08-12 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 79 RIVER BEND RD UNIT D |
| City | STRATFORD |
| State | CT |
| Zip Code | 06614-8090 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nicole Marie Minaudo | 80 Barrows Ter, Stratford, CT 06614 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Constance Greene | 65 Pamela Drive, Stratford, CT 06614 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Courtney M Blaze | 90 Mercer Street, Stratford, CT 06614 | Massage Therapist | 2020-07-01 ~ 2022-06-30 |
| William E Rosner Md | 81 B Seminole Lane, Stratford, CT 06614 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Demetrius I Mcqueen | 60 Emerald Pl, Stratford, CT 06614 | Real Estate Salesperson | 2020-06-26 ~ 2021-05-31 |
| Alan Goldberg | 1825 Barnum Ave, Stratford, CT 06614 | Dentist | 2020-09-01 ~ 2021-08-31 |
| Kimberly L Matakevich | 1367 Nichols Avenue, Stratford, CT 06614 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Marybeth Nemergut | 990 Chapel St, Stratford, CT 06614 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Geraldine C Corry | 135 Wigwam Lane, Stratford, CT 06614 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Kathleen Sajgovic | 300 Post Oak Rd, Stratford, CT 06614 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06614 | |||
| City | STRATFORD |
| Zip Code | 06614 |
| License Type | Advanced Practice Registered Nurse |
| License Type + County | Advanced Practice Registered Nurse + STRATFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jean C Ohliger | 96 Oak St, South Windsor, CT 06074 | Advanced Practice Registered Nurse | 2016-08-01 ~ 2017-07-31 |
| Jean Smith Aprn | 407 Woodbridge St, Manchester, CT 06040 | Advanced Practice Registered Nurse | 2014-09-01 ~ 2015-08-31 |
| Kathryn Jean Monroe | 1202 Yardley Ln, Wilmington, NC 28412-8429 | Advanced Practice Registered Nurse | ~ |
| Mary Jean Walker | 71 Philadelphia St, Teaticket, MA 02536-6748 | Advanced Practice Registered Nurse | 2012-07-01 ~ 2013-06-30 |
| Jean A Inge | 32 White Road, Ellington, CT 06029 | Advanced Practice Registered Nurse | 2002-10-16 ~ 2003-11-30 |
| Jean B Stielau Aprn | 564 Kelsey Street, Middletown, CT 06457 | Advanced Practice Registered Nurse | 2020-03-01 ~ 2021-02-28 |
| Emily Jean Ford | 5321 Lake Siena Dr, Wimauma, FL 33598-4440 | Advanced Practice Registered Nurse | 2020-04-24 ~ 2020-12-31 |
| Jean Mackay Aprn | 67 Hickory Hill Road, Simsbury, CT 06070 | Advanced Practice Registered Nurse | 2010-12-01 ~ 2011-11-30 |
| Jean H Mccormick Aprn | 1487 Herndon Dairy Road, Aiken, SC 29803 | Advanced Practice Registered Nurse | 2016-02-01 ~ 2017-01-31 |
| Daline Derival | 677 E 19th Street, Brooklyn, NY 11230 | Registered Nurse | 2018-01-02 ~ 2019-01-31 |
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| 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).