KATHRYN B FALLAVOLLITA
Controlled Substance Registration for Practitioner


Address: 110 Dean St Unit 59, Taunton, MA 02780-2754

KATHRYN B FALLAVOLLITA (Credential# 1300630) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is July 21, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.

Business Overview

KATHRYN B FALLAVOLLITA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0061027. The credential type is controlled substance registration for practitioner. The effective date is July 21, 2015. The expiration date is February 28, 2017. The business address is 110 Dean St Unit 59, Taunton, MA 02780-2754. The current status is inactive.

Basic Information

Licensee Name KATHRYN B FALLAVOLLITA
Credential ID 1300630
Credential Number CSP.0061027
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 110 Dean St Unit 59
Taunton
MA 02780-2754
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2015-07-21
Effective Date 2015-07-21
Expiration Date 2017-02-28
Refresh Date 2018-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
1299209 23.003383 Physician Assistant 2015-07-17 2016-03-01 - 2017-02-28 INACTIVE

Office Location

Street Address 110 DEAN ST UNIT 59
City TAUNTON
State MA
Zip Code 02780-2754

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Competitor

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City TAUNTON
Zip Code 02780
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + TAUNTON

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Dataset Information

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).

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