DANIELLE L PROVONCHA (Credential# 1250171) 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.
DANIELLE L PROVONCHA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0058880. 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 83 Wildwood Circle, Durham, CT 06422. The current status is active.
| Licensee Name | DANIELLE L PROVONCHA |
| Credential ID | 1250171 |
| Credential Number | CSP.0058880 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
83 Wildwood Circle Durham CT 06422 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2014-10-16 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-22 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1251906 | 12.006012 | Advanced Practice Registered Nurse | 2014-12-01 | 2020-01-01 - 2020-12-31 | ACTIVE |
| 593045 | 10.089043 | Registered Nurse | 2009-06-24 | 2020-01-01 - 2020-12-31 | ACTIVE |
| Street Address | 83 wildwood circle |
| City | Durham |
| State | CT |
| Zip Code | 06422 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nina R Mink | 83 Wildwood Circle, Durham, CT 06422 | Notary Public Appointment | 2003-07-28 ~ 2008-07-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jonathan A Luysterborghs | 208 Blue Hills Road, Durham, CT 06422 | Licensed Clinical Social Worker | 2020-08-01 ~ 2021-07-31 |
| Trinh Tu Tran | 10 Cesca Lane, Durham, CT 06422 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Beseck Mountain Rescue Inc | 68r Middlefield Road, Durham, CT 06422 | Public Charity-exempt From Financial Requirements | 2007-10-15 ~ |
| Mary E Gossart | 35 Maiden Lane, Durham, CT 06422 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Jayshreebahen Bidja · Little Rooster Liquors | 363 Main St, Durham, CT 06422 | Package Store Liquor | 2020-08-09 ~ 2021-08-08 |
| Erica Espinoza | 163 Stage Coach Rd, Durham, CT 06422 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Adrienne Lynn Deschnow | 419 R Johnson Lane, Durham, CT 06422 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Lynda S Collins · Robison | 649 Wallingford Road, Durham, CT 06422 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Pierino Peter Cascini | 425 Main Street, Durham, CT 06422 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Leila K Markunas | 250 Skeetclub Road, Durham, CT 06422 | Massage Therapist | 2020-09-01 ~ 2022-08-31 |
| Find all Licenses in zip 06422 | |||
| City | Durham |
| Zip Code | 06422 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Durham |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Danielle Lee Mallory | 141 Way Rd, Salem, CT 06420-3716 | Controlled Substance Registration for Practitioner | 2019-07-03 ~ 2021-02-28 |
| Kaitlyn M Way | 517 Danielle Way, Dayville, CT 06241-1334 | Controlled Substance Registration for Practitioner | 2019-07-15 ~ 2021-02-28 |
| Danielle C Neuberth Pa | 10 Cary Rd, Riverside, CT 06878-1313 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Danielle M Blake | 15 New St Apt 316, West Hartford, CT 06107-4231 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Danielle Miano | 303 Irving Dr, Wilmington, DE 19802-1215 | Controlled Substance Registration for Practitioner | 2020-04-17 ~ 2021-02-28 |
| Danielle A Digeronimo | 40 Mansfield Ave, Willimatic, CT 06226 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Danielle B Cameron | 20 York St Tmp 209, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2017-07-05 ~ 2019-02-28 |
| Danielle L Kempesta | 104 Sullivan Rd, Lisbon, CT 06351 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Danielle T Friedman | 337 W 138th St Apt 1g, New York, NY 10030-2033 | Controlled Substance Registration for Practitioner | 2017-03-31 ~ 2019-02-28 |
| Danielle M Loos Pa | 186 Plumtree Rd, Sunderland, MA 01375-9470 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on DANIELLE L PROVONCHA.
| 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).