ERIC M MASTROGIACOMO (Credential# 1352865) 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.
ERIC M MASTROGIACOMO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0062715. 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 205 Bayberry Rd, Saint Marys, PA 15857-2009. The current status is active.
| Licensee Name | ERIC M MASTROGIACOMO |
| Credential ID | 1352865 |
| Credential Number | CSP.0062715 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
205 Bayberry Rd Saint Marys PA 15857-2009 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2016-05-16 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1489402 | 1.058608-RES | Resident Physician | 2017-07-01 | 2017-07-01 - 2020-06-30 | ACTIVE |
| Street Address | 205 BAYBERRY RD |
| City | SAINT MARYS |
| State | PA |
| Zip Code | 15857-2009 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Priscilla R Phillips | 348 Center St, St Marys, PA 15857 | Registered Nurse | 1996-07-05 ~ 1997-08-31 |
| Cheryl L Krieg | 1455 Flower Valley Rd, St Marys, PA 15857 | Registered Nurse | 2000-02-22 ~ 2000-11-30 |
| G William Bardin | 100 N Michael St Ste 202, Saint Marys, PA 15857-1135 | Heating, Piping & Cooling Unlimited Journeyperson | 2013-09-01 ~ 2014-08-31 |
| Gloria J Thomas | 124 Lombardo Pl, Saint Marys, PA 15857-1218 | Speech and Language Pathologist | 2014-09-09 ~ 2015-09-30 |
| Naveen Singanamala | 467 Wolfel Ave, Saint Marys, PA 15857-1244 | Physician/surgeon | 2016-03-01 ~ 2017-02-28 |
| Ann T Vollmer | 145 Bestway St, Saint Marys, PA 15857-1279 | Licensed Practical Nurse | 2019-06-01 ~ 2020-05-31 |
| Pauline E Skok | 443 Brusselles St, Saint Marys, PA 15857-1507 | Registered Nurse - Temporary | 2016-01-22 ~ 2016-05-20 |
| Melissa A Uhl | 637 Vermont Rd, Saint Marys, PA 15857-3445 | Registered Nurse - Temporary | 2013-02-21 ~ 2013-06-21 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Pamela J Reeves | 106 Cottage Ct, Saint Marys, GA 31558-3513 | Hairdresser/cosmetician | 2020-04-01 ~ 2022-03-31 |
| Jennifer Kindle Hoey | 1627 Sandpiper Court, Saint Marys, GA 31558 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Darlene H Taylor | 1102 Sussex St, Saint Marys, GA 31558-3917 | Licensed Practical Nurse | ~ |
| Shih Tzus and Furbabies Inc | 346 Osprey Cir, Saint Marys, GA 31558-4144 | Animal Importer | 2017-01-01 ~ 2018-12-31 |
| Cassandra L Chapman | 33 Merrymont Ct, Saint Marys, GA 31558-4842 | Occupational Therapist Assistant | 2017-09-14 ~ 2019-07-31 |
| Candise Jones | 500 Flamingo Drive, Saint Marys, GA 31558 | Registered Nurse | 2019-03-01 ~ 2020-03-31 |
| Denise J Svoboda | 103 Flamingo Dr., Saint Marys, GA 31558 | Pharmacist | 2016-02-01 ~ 2018-01-31 |
| Robert M Kennison | 556 Cardinal Cir E, Saint Marys, GA 31558-4161 | Heating, Piping & Cooling Limited Journeyperson | ~ |
| Karlyn M Krist | Po Box 6593, Saint Marys, GA 31558-6593 | Real Estate Salesperson | 2000-10-24 ~ 2001-05-31 |
| Pro-pet LLC | 1400 Mckinley Rd, Saint Marys, OH 45885-1821 | Commercial Feed | 2017-01-30 ~ 2017-12-31 |
| Find all Licenses in SAINT MARYS | |||
| City | SAINT MARYS |
| Zip Code | 15857 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SAINT MARYS |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric R Scott | 650 Mix Ave Apt 5a, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Eric Fan Md | 200 Orchard St Ste 303, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eric Lin | 300 George St Ste 901, New Haven, CT 06511-6662 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eric J Balaguer Md | 31 River Rd Ste 100, Cos Cob, CT 06807-2152 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Eric Lao | 8 Sea Island, Glastonbury, CT 06033-1476 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eric Berard | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Eric Levy Md | 15 Valley Dr, Greenwich, CT 06831-5205 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Eric R. Arzubi Md | 4 Gonczy Rd, Westport, CT 06880-5102 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Eric Klein Dds | 55 East Ave, Norwalk, CT 06851 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eric S Choudhury | 420 Conestoga St, Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 2007-03-26 ~ 2008-02-29 |
Please comment or provide details below to improve the information on ERIC M MASTROGIACOMO.
| 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).