SAMUEL E PECKHAM (Credential# 1371991) 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.
SAMUEL E PECKHAM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0063804. 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 100 Tater Hill Rd, East Haddam, CT 06423-1601. The current status is active.
| Licensee Name | SAMUEL E PECKHAM |
| Credential ID | 1371991 |
| Credential Number | CSP.0063804 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
100 Tater Hill Rd East Haddam CT 06423-1601 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2016-08-12 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2018-12-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1371179 | 12.006659 | Advanced Practice Registered Nurse | 2016-08-10 | 2019-09-01 - 2020-08-31 | ACTIVE |
| 591755 | 10.087753 | Registered Nurse | 2009-01-20 | 2019-09-01 - 2020-08-31 | ACTIVE |
| 767556 | 43.000239 | Acupuncturist | 2002-11-12 | 2018-09-01 - 2020-08-31 | ACTIVE |
| Street Address | 100 TATER HILL RD |
| City | EAST HADDAM |
| State | CT |
| Zip Code | 06423-1601 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jennifer L Peckham | 100 Tater Hill Rd, East Haddam, CT 06423 | Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Tammie L Caverly | 158 Tater Hill Rd, East Haddam, CT 06423-1601 | Radiographer | 2014-01-30 ~ 2014-04-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Audrey H Kyle-oates | P O Box 23, East Haddam, CT 06423 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Roy Rogers | 18 Cove Road, East Haddam, CT 06423 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Allison L Cappitella Aprn | 31 Bogue Lane, East Haddam, CT 06423 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Staehly Farm Winery | 274-278 Town St, East Haddam, CT 06423 | Farmer's Market Permit | 2020-05-30 ~ 2021-05-29 |
| Gail Smoloski-heil · Smoloski | 155 Parker Road, East Haddam, CT 06423 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| J. Christopher Backes | 55 Main Street, East Haddam, CT 06423 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Rachael Finch | 342 Mt. Parnassus Road, East Haddam, CT 06423 | Medication Administration Certification | ~ |
| Change A Life Dog Rescue, Inc. · N/a | 9 Ridge Road, East Haddam, CT 06423 | Public Charity | 2020-06-11 ~ 2021-11-30 |
| George Fellner | P.o. Box 115, East Haddam, CT 06423 | Architect | 2020-08-01 ~ 2021-07-31 |
| Maureen K Goff | 180 Daniel Peck Rd, East Haddam, CT 06423 | Real Estate Salesperson | 2020-06-08 ~ 2021-05-31 |
| Find all Licenses in zip 06423 | |||
| City | EAST HADDAM |
| Zip Code | 06423 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + EAST HADDAM |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Earlene Peckham Aprn | 658 Chestnut Ridge Rd, Orange, CT 06477-2029 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Samuel H Yun | 20 York St Tmp 209, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Samuel L Siegler | 186 Coachmans Dr, Southbury, CT 06488 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Samuel Johnson Md | 26 Adams St, New Britain, CT 06052 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Samuel T Wilkinson | 100 York St Ste 2j, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Samuel G Alpert Md | 7 Gregory Pwy#83, Syracuse, NY 13214 | Controlled Substance Registration for Practitioner | 2004-02-29 ~ 2005-02-28 |
| Samuel Hahn Md | 57 Cambridge Rd, Guilford, CT 06437-1269 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Samuel Flynn | 114 Woodland St, Hartford, CT 06105-1208 | Controlled Substance Registration for Practitioner | 2019-07-18 ~ 2021-02-28 |
| Samuel P Sprotzer Md | 202 Cherry St, Milford, CT 06460 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Samuel Jones II | 543 W 141st St, New York, NY 10031-7026 | Controlled Substance Registration for Practitioner | 2019-04-08 ~ 2021-02-28 |
Please comment or provide details below to improve the information on SAMUEL E PECKHAM.
| 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).