JONATHAN MALLEN (Credential# 1281849) 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.
JONATHAN MALLEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0060041. 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 1365 Vincenzo Dr, Toms River, NJ 08753-2772. The current status is active.
| Licensee Name | JONATHAN MALLEN |
| Credential ID | 1281849 |
| Credential Number | CSP.0060041 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1365 Vincenzo Dr Toms River NJ 08753-2772 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-05-20 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2018-12-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1488654 | 1.058049-RES | Resident Physician | 2015-07-01 | 2015-07-01 - 2020-06-30 | ACTIVE |
| Street Address | 1365 VINCENZO DR |
| City | TOMS RIVER |
| State | NJ |
| Zip Code | 08753-2772 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sarah Elizabeth Phipps | 600 Clifton Ave, Toms River, NJ 08753 | Registered Nurse | ~ |
| Ronald A Sebring | 54 Aldo Court, Toms River, NJ 08753 | Architect | 2018-08-01 ~ 2019-07-31 |
| Eugene Robert Porzio | 149 Arizona Ave, Toms River, NJ 08753 | Professional Engineer | 2014-02-01 ~ 2015-01-31 |
| Kellie Adrienne Ebberup-krug | P.o. Box 324, Brooklyn, CT 08753 | Licensed Clinical Social Worker | 2019-09-23 ~ 2020-08-31 |
| Rebecca Alonso | 263 South Shore Drive, Toms River, NJ 08753 | Registered Nurse | 2019-10-01 ~ 2020-09-30 |
| Stop & Shop Pharmacy #811 | 353 Route # 37e, Toms River, NJ 08753 | Nonresident Pharmacy | 2018-09-01 ~ 2019-08-31 |
| Robert M Ceppaluni | 1856 Hidden Brook Ct, Toms River, NJ 08753 | Locksmith | 2019-01-01 ~ 2020-12-31 |
| Judith Franchetti | 8 Grand Ave, Toms River, NJ 08753 | Real Estate Salesperson | 2004-07-30 ~ 2005-05-31 |
| Micheal T Zurawski | 865 Tudor Dr, Toms River, NJ 08753 | Real Estate Salesperson | 2003-07-14 ~ 2004-05-31 |
| Charlene Diaz | 537 Duchess Ct, Toms River, NJ 08753 | Real Estate Salesperson | 2004-08-12 ~ 2005-05-31 |
| Find all Licenses in zip 08753 | |||
| City | TOMS RIVER |
| Zip Code | 08753 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + TOMS RIVER |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jonathan Uhl | 227 Coppermine Rd, Unionville, CT 06085-1528 | Controlled Substance Registration for Practitioner | 2020-03-10 ~ 2021-02-28 |
| Jonathan P Shepherd | 219 Elm St, Swissvale, PA 15218-1517 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jonathan T Orr | 37 Ridge Rd, Danbury, CT 06810-6362 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jonathan L Nelson Md | 33 Cedar St Ste 6, Rye, NY 10580-2031 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Jonathan S. Mittelman | 175 Wingood Rd, Windsor, ME 04363-3707 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Jonathan R Genzen Md | 999 Townsend Ave, New Haven, CT 06512 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Jonathan R Hamilton | 1 Hart Ct, Oxford, CT 06478-1590 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jonathan M Babiarz | 215 State St, Guilford, CT 06437 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jonathan D. Hirsch | 68 S Service Rd Ste 350, Melville, NY 11747-2358 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Jonathan S Siegfried | 46 Prince St Ste 310, New Haven, CT 06519-1600 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).