CHEYENNE DOUGLAS (Credential# 1441503) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is August 9, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
CHEYENNE DOUGLAS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0066522. The credential type is controlled substance registration for practitioner. The effective date is August 9, 2017. The expiration date is February 28, 2019. The business address is 25 West Rd, Canton, CT 06019-3739. The current status is lapsed.
| Licensee Name | CHEYENNE DOUGLAS |
| Credential ID | 1441503 |
| Credential Number | CSP.0066522 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
25 West Rd Canton CT 06019-3739 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2017-08-09 |
| Effective Date | 2017-08-09 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1417665 | 10.143068 | Registered Nurse | 2017-07-07 | 2017-12-01 - 2018-11-30 | INACTIVE |
| 1433535 | 12.007144 | Advanced Practice Registered Nurse | 2017-08-07 | 2017-12-01 - 2018-11-30 | INACTIVE |
| Street Address | 25 WEST RD |
| City | CANTON |
| State | CT |
| Zip Code | 06019-3739 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Peter M Pearson Jr | 51 West Road, Canton, CT 06019-3739 | Emergency Medical Technician | 2007-11-15 ~ 2009-04-01 |
| 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 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + CANTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cheyenne M Beach | Po Box 208064, New Haven, CT 06520-8064 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Easton R Douglas Dds | 217 Deerfield Rd, Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
| Douglas N Macgregor Md | 50 Union St, Ellsworth, ME 04605-1534 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2015-07-10 |
| Douglas M Bernstein | 39 Alston Ave, New Haven, CT 06515 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Douglas W Greenlaw Dmd | 45 Cobblestone Rd, Glastonbury, CT 06033 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Douglas Olson | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Douglas J Davis | 30 Kneeland Rd, New Haven, CT 06512-5005 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Douglas M Kahn Md | 33 Germantown Rd, Danbury, CT 06810-5038 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Douglas A Berv Md | 60 Washington Ave, Hamden, CT 06518 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Shanise Perez | 17 Douglas Rd Apt 312, Whitinsville, MA 01588-2028 | Controlled Substance Registration for Practitioner | 2019-07-22 ~ 2021-02-28 |
Please comment or provide details below to improve the information on CHEYENNE DOUGLAS.
| 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).