DEAN A BASULTO (Credential# 1333474) 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.
DEAN A BASULTO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0062111. 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 1482 Christine Rd, Mohegan Lake, NY 10547. The current status is active.
| Licensee Name | DEAN A BASULTO |
| Credential ID | 1333474 |
| Credential Number | CSP.0062111 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1482 Christine Rd Mohegan Lake NY 10547 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2016-02-18 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1282299 | 1.054860 | Physician/Surgeon | 2016-01-13 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 1482 Christine Rd |
| City | Mohegan Lake |
| State | NY |
| Zip Code | 10547 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Donna J Zuck | 3139 East Main St, Mohegan Lake, NY 10547 | Tax Preparer/facilitator Permit | 2020-03-04 ~ 2022-03-31 |
| Lew Strumpf | 3139 E Main Street Ste 29, Mohegan Lake, NY 10547 | Tax Preparer/facilitator Permit | 2020-03-04 ~ 2022-03-31 |
| Nicole Cristofaro | 3713 Marcy St, Mohegan Lake, NY 10547 | Tax Preparer/facilitator Permit | 2020-02-14 ~ 2022-02-28 |
| Ramanjit S Dhanoa | 1332 Judy Rd, Mohegan Lake, NY 10547 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
| Dana Sedlak | 233 Pine Road, Briarcliff Manor, NY 10547 | Licensed Clinical Social Worker | ~ |
| Nichole Michelle Riehm | 1498 Dover Street, Mohegan Lake, NY 10547 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Donald M Campbell | 1427 Inspiration Road, Mohegan Lake, NY 10547 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Swati Sreedharan | 2923 Lexington Ave, Mohegan Lake, NY 10547 | Physical Therapist | 2020-01-01 ~ 2020-12-31 |
| Jennifer A Cusano | 1437 Delawre Rd, Mohegan Lake, NY 10547 | Notary Public Appointment | 2019-02-01 ~ 2024-02-29 |
| Katie Anne Fernandez | 2665 Deer Street, Mohegan Lake, NY 10547 | Notary Public Appointment | 2014-04-10 ~ 2019-04-30 |
| Find all Licenses in zip 10547 | |||
| City | Mohegan Lake |
| Zip Code | 10547 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Mohegan Lake |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Voichita E Ianas Md | 6 Dean St Apt 3, Danbury, CT 06810 | Controlled Substance Registration for Practitioner | 2004-02-06 ~ 2005-02-28 |
| Dean A Schaffer | 523 N. Main St., Stonington, CT 06378 | Controlled Substance Registration for Practitioner | 2009-02-25 ~ 2011-02-28 |
| Beth A Dean Pa-c | 67 Hildurcrest Dr, Simsbury, CT 06070-2757 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sarah E Dean | 233 Berlin Ave, Southington, CT 06489-3252 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| John W Dean IIi | 123 York St., New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Dean Har Md | 2080 Bridgeport Ave Ste B, Milford, CT 06460-4647 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Dean G Cloutier Dds | 123 York St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Dean J Yimoyines | 87 Grandview Ave, Waterbury, CT 06708 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kenneth Dean | 114 Woodland St, Hartford, CT 06105-1208 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Dean E Adams Md | 156 Salem Dr, Cromwell, CT 06416 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
Please comment or provide details below to improve the information on DEAN A BASULTO.
| 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).