TINA MARIE GARDNER (Credential# 1419051) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
TINA MARIE GARDNER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.057109. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 461 Cherry Brook Road, Canton, CT 06019. The current status is active.
| Licensee Name | TINA MARIE GARDNER |
| Credential ID | 1419051 |
| Credential Number | 1.057109 |
| Credential Type | Physician/Surgeon |
| Business Address |
461 Cherry Brook Road Canton CT 06019 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-10-11 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-03-16 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1614519 | CSP.0069862 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-11-14 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 525863 | CSP.0045160 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-03-04 | 2009-03-04 - 2011-02-28 | INACTIVE |
| Street Address | 461 Cherry Brook Road |
| City | Canton |
| State | CT |
| Zip Code | 06019 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Laurie E Dunford | 483 Dowd Ave., Canton, CT 06019 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Christine M Jencik | 71 Cherrybrook Road, Canton, CT 06019 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Marie B Valley | P.o. Box 284, Canton, CT 06019 | Dental Hygienist | 2020-07-01 ~ 2021-06-30 |
| Stephen S Burgess | 275 Barbourtown Rd, Canton, CT 06019 | Architect | 2020-08-01 ~ 2021-07-31 |
| Lenore Quintal-bean | 26 North St, Collinsville, CT 06019 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Aubrey J Hoyt | 82 Lovely Street, Canton, CT 06019 | Radiographer | 2020-08-01 ~ 2021-07-31 |
| Julie Reed | 41 Wickhams Fancy, Collinsville, CT 06019 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| Sylvia Dibiasi | 93 Cherry Brook Road, Canton, CT 06019 | Physical Therapist | 2020-08-01 ~ 2021-07-31 |
| Nora Baumgart | 60 Cherry Brook Rd, Canton, CT 06019 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Donald Tarinelli | 4 Center St, Collinsville, CT 06019 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06019 | |||
| City | Canton |
| Zip Code | 06019 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Canton |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Stuart W Gardner | 112 Blake Rd, Hamden, CT 06517-3402 | Physician/surgeon | 2016-05-01 ~ 2017-04-30 |
| Maryann Gardner Md | Plaucher Orthopedics, Cos Cob, CT 06807 | Physician/surgeon | 2008-03-11 ~ 2009-04-30 |
| Jesus Blanco | 76 Crestwood Dr, Gardner, MA 01440 | Physician/surgeon | 1997-09-11 ~ 1998-09-30 |
| Charles S Gardner | 409 Field Pt Rd, Greenwich, CT 06830 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Tina Sindwani | 390 11th Ave Fl 2, New York, NY 10001-1208 | Physician/surgeon | ~ |
| Tina Yin Chang | 701 5th Ave, Seattle, WA 98104 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Mark L Gardner | 246 Court St, West Haven, CT 06516 | Physician/surgeon | 1991-12-20 ~ 1992-12-31 |
| Guillermo B Avecilla Jr | 1597 No Gardner Dr, Bayshore, NY 11706 | Physician/surgeon | 1994-06-15 ~ 1995-06-30 |
| Charles W Gardner Jr | 100 Verna Hill Rd, Fairfield, CT 06824-2158 | Physician/surgeon | 2011-11-01 ~ 2012-10-31 |
| Carmen Sophie Gardner | 635 Canyon Rd, Oakland Twp, MI 48306 | Physician/surgeon | 2019-07-05 ~ 2020-01-31 |
Please comment or provide details below to improve the information on TINA MARIE GARDNER.
| 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).