KELLY M THIBODEAU (Credential# 1455491) 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.
KELLY M THIBODEAU is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0066944. 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 109 Browns Bridge Rd, Tolland, CT 06084. The current status is active.
| Licensee Name | KELLY M THIBODEAU |
| Credential ID | 1455491 |
| Credential Number | CSP.0066944 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
109 Browns Bridge Rd Tolland CT 06084 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-10-11 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1442637 | 12.007297 | Advanced Practice Registered Nurse | 2017-10-10 | 2019-10-01 - 2020-09-30 | ACTIVE |
| 887919 | 10.089713 | Registered Nurse | 2009-07-27 | 2019-10-01 - 2020-09-30 | ACTIVE |
| Street Address | 109 Browns Bridge Rd |
| City | Tolland |
| State | CT |
| Zip Code | 06084 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Janice M Heldmann-o'connell · Heldmann | 18 Thomas Dr, Tolland, CT 06084 | Respiratory Care Practitioner | 2020-08-01 ~ 2021-07-31 |
| Barbara Ann Stebbins | 18 Midland Drive, Tolland, CT 06084 | Registered Nurse | ~ |
| Carrie Elizabeth Gill | 63 Hill Top Road, Tolland, CT 06084 | Behavior Analyst | ~ |
| Kollas Apple Orchard | 41 New Rd, Tolland, CT 06084 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Frederick M Daniels Dds | 12 Goose Lane, Tolland, CT 06084 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Pat's Power Equipment LLC | 401 Merrow Rd, Tolland, CT 06084 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Keri A Johnson | 224 Buff Cap Rd, Tolland, CT 06084 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Clifford Vernor Dunn, IIi | 44 Birch Hill Dr., Tolland, CT 06084 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Aimee Wendy Johnson | 175 South River Rd, Tolland, CT 06084 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Peter D Staiger Md | David E. Palozej Eyecare Associates, Tolland, CT 06084 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06084 | |||
| City | Tolland |
| Zip Code | 06084 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Tolland |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kaylan Marie Thibodeau | 11 High Meadow Rd, Feeding Hills, MA 01030-1248 | Controlled Substance Registration for Practitioner | 2019-08-05 ~ 2021-02-28 |
| Kelly Gullotta | Po Box 465, Brownsville, VT 05037-0465 | Controlled Substance Registration for Practitioner | 2020-04-09 ~ 2021-02-28 |
| Kelly M. Doran Md | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Kelly J Way | 34 B Springbrook Rd, Westerly, RI 02891 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly M Ferjentsik | 34 Little Fox Ln, Monroe, CT 06468-1607 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly M Deforest | 267 Rte 87, Columbia, CT 06237 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Syed S A Hasni Md | 24 Kelly Dr, Marlton, NJ 08053-9701 | Controlled Substance Registration for Practitioner | 2011-03-07 ~ 2013-02-28 |
| Kelly A Toth | 120 Mikayla Ln, Prospect, CT 06712-1497 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly E Palchik | 17 Crofut Ln, Roxbury, CT 06783 | Controlled Substance Registration for Practitioner | 2019-04-03 ~ 2021-02-28 |
| Kelly L Coderre | 290 Route 171, Woodstock, CT 06281-3127 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on KELLY M THIBODEAU.
| 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).