RAJ B PENUMETSA (Credential# 1316187) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
RAJ B PENUMETSA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0061615. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 75 Hockanum Blvd Unit 2221, Vernon, CT 06066-4072. The current status is lapsed.
| Licensee Name | RAJ B PENUMETSA |
| Credential ID | 1316187 |
| Credential Number | CSP.0061615 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
75 Hockanum Blvd Unit 2221 Vernon CT 06066-4072 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2015-10-27 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1311475 | 1.054681 | Physician/Surgeon | 2015-10-08 | 2016-09-01 - 2017-08-31 | INACTIVE |
| Street Address | 75 HOCKANUM BLVD UNIT 2221 |
| City | VERNON |
| State | CT |
| Zip Code | 06066-4072 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lauren E. Haines | 75 Hockanum Blvd Unit 2137, Vernon Rockville, CT 06066-4072 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Rosemary Wood | 75 Hockanum Blvd Unit 2227, Vernon, CT 06066-4072 | Physical Therapist | 2020-07-01 ~ 2021-06-30 |
| Robin Teets | 75 Hockanum Blvd Unit 1736, Vernon Rockville, CT 06066-4072 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Ethan L. Chevrette | 75 Hockanum Blvd Unit 2313, Vernon Rockville, CT 06066-4072 | Certified Public Accountant License | 2020-01-01 ~ 2020-12-31 |
| Michael G Gaughran | 75 Hockanum Blvd Unit 2313, Vernon Rockville, CT 06066-4072 | Certified Public Accountant License | 2020-01-01 ~ 2020-12-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cynthia Stelma | 35 White St, Vernon, CT 06066 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Diana C Mendieta | 127 Lake St, Vernon, CT 06066 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-02-28 |
| Taylor Rose Mulcahy | 95 Hockanum Blvd Unit #5223, Vernon, CT 06066 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Eric Scott · E Scott Const | 27 Lawrence St, Vernon Rockville, CT 06066 | Home Improvement Contractor | 2020-06-20 ~ 2020-11-30 |
| Margaret A Lucerini | 27 Rosewood Dr, Vernon, CT 06066 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Alexander John Bozzi | 28 Deepwood Dr, Vernon, CT 06066 | Home Inspector Intern | 2020-05-30 ~ 2021-06-30 |
| Kathleen N Laplaca | 244 Risley Road, Vernon, CT 06066 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Shawnda Shelton | 215 East Main St. #25, Vernon, CT 06066 | Medication Administration Certification | 2020-06-05 ~ 2022-06-04 |
| Ireland Oil Co Inc | 171 Union St, Vernon, CT 06066 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Annmarie Margaret Fultz | 1a Prospect St, Vernon Rockville, CT 06066 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Find all Licenses in zip 06066 | |||
| City | VERNON |
| Zip Code | 06066 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + VERNON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Shu Pan | 360 State St Apt 702, New Haven, CT 06510-3602 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| May Chaaban | Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 2016-08-01 ~ 2017-02-28 |
Please comment or provide details below to improve the information on RAJ B PENUMETSA.
| 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).