ERIC MORTENSEN (Credential# 1386084) 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 MORTENSEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0064260. 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 5 Pinnacle Mountain Road, Simsbury, CT 06070. The current status is active.
| Licensee Name | ERIC MORTENSEN |
| Credential ID | 1386084 |
| Credential Number | CSP.0064260 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
5 Pinnacle Mountain Road Simsbury CT 06070 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2016-10-26 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2018-12-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1380354 | 1.055864 | Physician/Surgeon | 2016-10-25 | 2020-01-01 - 2020-12-31 | ACTIVE |
| Street Address | 5 Pinnacle Mountain road |
| City | Simsbury |
| State | CT |
| Zip Code | 06070 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Henry Withers | 571 Hopmeadow St, Simsbury, CT 06070 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Nancy W Flanagan | 9 Carver Circle, Simsbury, CT 06070 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Catharina A Bates | 12 East View Dr., Simsbury, CT 06070 | Real Estate Salesperson | 2020-06-25 ~ 2021-05-31 |
| Faith E Preato | 25 Squadron Line Rd, Simsbury, CT 06070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Diane Bragoni | 542 Hopmeadow Street, #128, Simsbury, CT 06070 | Architect | 2020-08-01 ~ 2021-07-31 |
| Virginia S Durst · Banks | 20 Woodcliff Drive, Simsbury, CT 06070 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Caitlin M Cornier | 18 Saxton Brook Drive, Simsbury, CT 06070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Nancy L Alleva · Maule | 1079 Hopmeadow St, Simsbury, CT 06070 | Respiratory Care Practitioner | 2020-09-01 ~ 2021-08-31 |
| Stephen R Birghenti · Simsbury Inn | 397 Hopmeadow St, Simsbury, CT 06070 | Hotel Liquor (50000 Or More Population) | 2019-08-14 ~ 2020-12-13 |
| Deborah L Poniatowski · Blase | 35 Munnisunk Dr, Simsbury, CT 06070 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06070 | |||
| City | Simsbury |
| Zip Code | 06070 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Simsbury |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Peter E Mortensen Aprn | 385 Lake Rd, Andover, CT 06232 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Eric Fan Md | 200 Orchard St Ste 303, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eric Lao | 8 Sea Island, Glastonbury, CT 06033-1476 | 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 R Scott | 650 Mix Ave Apt 5a, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Eric Cryan Dvm | 11 Goodchild St, Milford, CT 06460 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Eric Schwaber | 130 Division St, Derby, CT 06418-1326 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eric B Neadel Pa | 12 Academy St # 5, New Haven, CT 06511-6973 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eric C Palluotto | 230 Old Lane Rd, Cheshire, CT 06410 | Controlled Substance Registration for Practitioner | 2019-07-17 ~ 2021-02-28 |
Please comment or provide details below to improve the information on ERIC MORTENSEN.
| 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).