JENISE KWAK (Credential# 1435058) 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 INACTIVE.
JENISE KWAK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0066112. 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 700 Bloomfield Ave Apt 302, Bloomfield, CT 06002-2459. The current status is inactive.
| Licensee Name | JENISE KWAK |
| Credential ID | 1435058 |
| Credential Number | CSP.0066112 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
700 Bloomfield Ave Apt 302 Bloomfield CT 06002-2459 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LACK OF ACTIVE MEDICAL LICENSE |
| Issue Date | 2017-07-04 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-04-24 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1429495 | 2.011851 | Dentist | 2017-06-30 | 2018-10-01 - 2019-09-30 | INACTIVE |
| Street Address | 700 BLOOMFIELD AVE APT 302 |
| City | BLOOMFIELD |
| State | CT |
| Zip Code | 06002-2459 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patricia A Barone | 750 Bloomfield Ave Unit 534, Bloomfield, CT 06002-2459 | Licensed Clinical Social Worker | 2020-02-01 ~ 2021-01-31 |
| Hashim F Gibril | 20 Reed Ct, Bloomfield, CT 06002-2459 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Christopher Leighton Norkus | 700 Bloomfield Ave Apt 123, Bloomfield, CT 06002-2459 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paula L Raines | 92 Daniel Blvd, Bloomfield, CT 06002 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Kesone Taletia Telfer | 36 Walsh Street, Bloomfield, CT 06002 | Advanced Practice Registered Nurse | ~ |
| Joan Zito Upton | 106 Duncaster Road, Bloomfield, CT 06002 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Sheri M Sparks | Primary Eye Care Center, Bloomfield, CT 06002 | Optometrist | 2020-09-01 ~ 2021-08-31 |
| Kaman Aerospace Corporation | Old Windsor Road, Bloomfield, CT 06002 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Healing Meals Foundation Corporation | Po Box 7223, Bloomfield, CT 06002 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Taylor A West | 5 Tiffany Ln, Bloomfield, CT 06002 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Emma J Ranel | 53 Burr Road, Bloomfield, CT 06002 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Dorothy W Field | 177 Oliver Way, Bloomfield, CT 06002 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Carol J Mortensen | 6 Maple Edge Dr, Bloomfield, CT 06002 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06002 | |||
| City | BLOOMFIELD |
| Zip Code | 06002 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BLOOMFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Young J. Kwak | 400 Blake St Apt 4417, New Haven, CT 06515-4421 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kwak | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2018-09-01 ~ 2021-08-30 |
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on JENISE KWAK.
| 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).