HANNAH SLACK (Credential# 1379093) 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.
HANNAH SLACK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0064042. 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 99 Goodrich Rd, Harveys Lake, PA 18618-7855. The current status is active.
| Licensee Name | HANNAH SLACK |
| Credential ID | 1379093 |
| Credential Number | CSP.0064042 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
99 Goodrich Rd Harveys Lake PA 18618-7855 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2016-09-15 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1372559 | 23.003674 | Physician Assistant | 2016-09-14 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 99 GOODRICH RD |
| City | HARVEYS LAKE |
| State | PA |
| Zip Code | 18618-7855 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Krystle Dawn Winter | 1141 Halowich Rd, Harveys Lake, PA 18618-2028 | Registered Nurse - Temporary | 2018-08-08 ~ 2018-12-05 |
| Darcelle S Hooke | 235 Noxen Rd, Harveys Lake, PA 18618-3193 | Licensed Practical Nurse | 2014-10-01 ~ 2015-09-30 |
| Rose A Sholtis | 174 Rr 1, Harveys Lake, PA 18618-9738 | Registered Nurse - Temporary | 2010-11-05 ~ 2011-03-05 |
| Jason Covert | 326 Rr 1, Harveys Lake, PA 18618-9762 | Tv & Radio Limited Dish Antenna Technician | 2010-09-09 ~ 2011-08-31 |
| City | HARVEYS LAKE |
| Zip Code | 18618 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + HARVEYS LAKE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Caryn Kendra Slack | Hartford, CT 06105 | Controlled Substance Registration for Practitioner | 2004-02-29 ~ 2005-02-28 |
| Frank J Slack | 266 Whitney Ave, New Haven, CT 06511-8902 | Controlled Substance Laboratory | 2012-02-01 ~ 2013-01-31 |
| Hannah Ahn | 329 Riverside Ave, Westport, CT 06880-4810 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hannah B Jackson | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Hannah A Whitehead | 303 Shore Rd, Greenwich, CT 06830-7046 | Controlled Substance Registration for Practitioner | 2014-02-03 ~ 2015-02-28 |
| Hannah N Russell | 20 York St., New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2016-12-20 ~ 2018-07-02 |
| Hannah R Feldman Pa-c | 466 Malbone St #3, Brooklyn, NY 11225 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Hannah M Castrucci Md | 47 Rawley Dr, Hampden, ME 04444-1137 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Hannah Martin | 20 York St., New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Hannah J Yu | 1450 Chapel St # 136, New Haven, CT 06511-4440 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
Please comment or provide details below to improve the information on HANNAH SLACK.
| 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).