KATHLEEN L BROAD
Controlled Substance Registration for Practitioner


Address: 950 Campbell Ave Rm 151d, West Haven, CT 06516-2770

KATHLEEN L BROAD (Credential# 1345644) 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.

Business Overview

KATHLEEN L BROAD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0062470. 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 950 Campbell Ave Rm 151d, West Haven, CT 06516-2770. The current status is lapsed.

Basic Information

Licensee Name KATHLEEN L BROAD
Credential ID 1345644
Credential Number CSP.0062470
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 950 Campbell Ave Rm 151d
West Haven
CT 06516-2770
Business Type INDIVIDUAL
Status LAPSED
Active 1
Issue Date 2016-04-16
Effective Date 2017-03-01
Expiration Date 2019-02-28
Refresh Date 2019-03-06

Other licenses

ID Credential Code Credential Type Issue Term Status
1332029 1.055144 Physician/Surgeon 2016-04-07 2016-11-01 - 2017-10-31 INACTIVE

Office Location

Street Address 950 CAMPBELL AVE RM 151D
City WEST HAVEN
State CT
Zip Code 06516-2770

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Laura J Davis 950 Campbell Ave # 240, West Haven, CT 06516-2770 Physician/surgeon 2020-04-01 ~ 2021-03-31
Elissa Mccarthy 950 Campbell Ave Bldg 1, West Haven, CT 06516-2770 Psychologist 2020-05-01 ~ 2021-04-30
Jeffrey H Kerner West Haven Va Hospital, West Haven, CT 06516-2770 Physician/surgeon 2020-05-01 ~ 2021-04-30
Niyati Dhand 950 Campbell Ave # 151d, West Haven, CT 06516-2770 Controlled Substance Registration for Practitioner 2017-07-13 ~ 2019-02-28
Dana R. Saldaitis 950 Campbell Ave Acsl 11, West Haven, CT 06516-2770 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Philip Chui 950 Campbell Ave Bldg 35a, West Haven, CT 06516-2770 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Gihyun Yoon 950 Campbell Ave Bldg. 35 151d, West Haven, CT 06516-2770 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Roopa Sethi 950 Campbell Ave # 151-d, West Haven, CT 06516-2770 Controlled Substance Registration for Practitioner 2013-03-01 ~ 2015-02-28
Henry J Taylor Iv 950 Campbell Ave, West Haven, CT 06516-2770 Resident Podiatrist 2020-07-01 ~ 2021-06-30
Brittany L Hervey 950 Campbell Ave, West Haven, CT 06516-2770 Resident Podiatrist 2020-07-01 ~ 2021-06-30
Find all Licenses in zip 06516-2770

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Nancy Cabrera Salinas 649 Third Ave., West Haven, CT 06516 Combination Nail Technician, Esthetician Or Eyelash Technici 2020-06-27 ~ 2021-07-31
Lauralee L Gaglio 27 Peppermill Drive, West Haven, CT 06516 Hairdresser/cosmetician 2020-07-01 ~ 2022-06-30
Evelyn Ruiz Conant 309 Terrace Ave, Unit 42, West Haven, CT 06516 Combination Nail Technician, Esthetician Or Eyelash Technici ~
Junqin Wang 15 Central Ave West Haven, West Haven, CT 06516 Nail Technician ~
Mehmet Sofuoglu Md Va Conn Healthcare System, West Haven, CT 06516 Physician/surgeon 2020-09-01 ~ 2021-08-31
Monica M Skakacz 19 Cowpen Rd, West Haven, CT 06516 Registered Nurse 2020-05-01 ~ 2021-04-30
Lourdes Maribel Guzman 26 York Street, West Haven, CT 06516 Combination Nail Technician, Esthetician Or Eyelash Technici ~
Mcdonald's · Tay Mac Dba 1129 Campbell Ave, West Haven, CT 06516 Bakery 2020-07-01 ~ 2021-06-30
Dyaija Soriano 29 Ridge Court East, West Haven, CT 06516 Esthetician 2020-06-26 ~ 2022-05-31
Katherine M Grable 13 Perry Merrill Drive, West Haven, CT 06516 Licensed Practical Nurse 2020-07-01 ~ 2021-06-30
Find all Licenses in zip 06516

Competitor

Search similar business entities

City WEST HAVEN
Zip Code 06516
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WEST HAVEN

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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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