EVAN P PROVISOR (Credential# 147776) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2009. The license expiration date date is February 28, 2011. The license status is INACTIVE.
EVAN P PROVISOR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0010795. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2009. The expiration date is February 28, 2011. The business address is Fiskdale, MA 01518-1043. The current status is inactive.
| Licensee Name | EVAN P PROVISOR |
| Credential ID | 147776 |
| Credential Number | CSP.0010795 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
Fiskdale MA 01518-1043 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 2009-03-01 |
| Expiration Date | 2011-02-28 |
| Refresh Date | 2013-03-07 |
| City | Fiskdale |
| State | MA |
| Zip Code | 01518-1043 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Dawn Kelley | 13 Old Towne Way, Sturbridge, MA 01518-1043 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Pamela A Provisor | 7 Old Towne Way, Fiskdale, MA 01518-1043 | Registered Nurse | 2019-08-01 ~ 2020-07-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Charles P Everson, Jr. | 12 Laflamme Ln., Fiskdale, MA 01518 | Backflow Prevention Device Tester | 2020-04-01 ~ 2023-03-31 |
| Shannon Elizabeth Sullivan | 6 Wildwood Lane, Sturbridge, MA 01518 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Sherry Diane | 110 Leadmine Lane, Fiskdale, MA 01518 | Speech and Language Pathologist | 2020-06-01 ~ 2021-05-31 |
| Rachel Ann Kopacz | 59 Brookfield Road, Fiskdale, MA 01518 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Victoria Allen Masse | 24 Camp Rd, Fiskdale, MA 01518 | Notary Public Appointment | 2018-02-01 ~ 2023-02-28 |
| Janina Piascik | 56 Clark Road, Fiskdale, MA 01518 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Colonial Restorations LLC | 43 Collette Rd, Fiskdale, MA 01518 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Kimberly Mary Jorge | 588 Main Street, Sturbridge, MA 01518 | Registered Nurse | 2020-01-01 ~ 2020-12-31 |
| Bryan Matter · Handyman Service | 6 Lauren Lane, Fiskdale, MA 01518 | Home Improvement Contractor | 2017-12-01 ~ 2018-11-30 |
| Lisa A Byam-mooney · Goldberg | 84 A Paradise Lane, Sturbridge, MA 01518 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Find all Licenses in zip 01518 | |||
| City | Fiskdale |
| Zip Code | 01518 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Fiskdale |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Evan Fox | 300 Hebron Ave Ste 107, Glastonbury, CT 06033 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Evan W Jones | 475 Main St Apt 4l, New York, NY 10044-0087 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| George Seddon Dds | 108 Evan Rd, Southington, CT 06489 | Controlled Substance Registration for Practitioner | 2003-03-01 ~ 2004-02-28 |
| Evan Woodford | 24 Hospital Ave, Danbury, CT 06810-6099 | Controlled Substance Registration for Practitioner | 2019-05-09 ~ 2021-02-28 |
| Evan J Fertig | 12 Doren Ave, Hamden, CT 06517 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Evan H Lee | 4209 163rd St Fl 2, Flushing, NY 11358-2617 | Controlled Substance Registration for Practitioner | 2017-08-03 ~ 2019-02-28 |
| Evan J Burke | 100 Retreat Ave, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-04-01 ~ 2021-02-28 |
| Evan Vosburgh Md | 54 Morningside Drive, New York, NY 10025 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Evan D Christensen Dds | 61 Sherman Street, Farifield, CT 06824 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Evan R Hack | 120 Park Lane, New Milford, CT 06776 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on EVAN P PROVISOR.
| 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).