MICHAEL H ELLSWORTH MD (Credential# 149069) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
MICHAEL H ELLSWORTH MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0004887. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 255 Pomfret St, Putnam, CT 06260. The current status is lapsed.
| Licensee Name | MICHAEL H ELLSWORTH MD |
| Credential ID | 149069 |
| Credential Number | CSP.0004887 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
255 Pomfret St Putnam CT 06260 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 541119 | 1.014465 | Physician/Surgeon | 1970-06-24 | 2017-03-01 - 2018-02-28 | INACTIVE |
| Street Address | 255 POMFRET ST |
| City | PUTNAM |
| State | CT |
| Zip Code | 06260 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eui K Chung Md | 255 Pomfret St, Putnam, CT 06260 | Physician/surgeon | 2006-03-22 ~ 2007-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Amanda L Neal | 69 Hawkins Road, Putnam, CT 06260 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Kellys Tire Inc | 306 School St, Putnam, CT 06260 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Donna Dumas | 19 Arthur Street, Putnam, CT 06260 | Medication Administration Certification | 2020-07-16 ~ 2022-07-15 |
| Mcdonalds #13538 | 6 Rpovidence Pike, Putnam, CT 06260 | Frozen Dessert Retailer | 2020-06-22 ~ 2020-12-31 |
| Cynthia C Paquin | 95 Elvira Heights Road, Putnam, CT 06260 | Dental Hygienist | 2018-11-01 ~ 2019-10-31 |
| Scott J Grimmett · Price Chopper | 251 Kennedy Drive Ste A, Putnam, CT 06260 | Grocery Beer | 2020-08-08 ~ 2021-08-07 |
| Lyne A Grillo · Fauteux | 73-155 Perry St, Putnam, CT 06260 | Radiographer | 2020-09-01 ~ 2021-08-31 |
| Crossings Restaurant and Brew Pub (the) | 45-47 Main St, Putnam, CT 06260 | Manufacturer for Beer and Brew Pub | 2019-11-26 ~ 2021-03-25 |
| June Elizabeth Foley | 4 Libertyhighway, Putnam, CT 06260 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Kevin J Bates · K J B Bldg Works | 7 Rowe St, Putnam, CT 06260 | Home Improvement Contractor | 2020-06-12 ~ 2020-11-30 |
| Find all Licenses in zip 06260 | |||
| City | PUTNAM |
| Zip Code | 06260 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PUTNAM |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lara K Labarbera | 64 Ellsworth Ln, Canton, CT 06019-2652 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tiffany C Zigras | 267 Ellsworth St, Bridgeport, CT 06605-3165 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Douglas N Macgregor Md | 50 Union St, Ellsworth, ME 04605-1534 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2015-07-10 |
| Elchanan Bruckheimer Md | 432 Ellsworth Ave, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
| Bernard D Bienstock Md | 387 Ellsworth Ave, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 1994-06-28 ~ 1996-07-01 |
| Erin K Cooley Pa-c | 6 Ellsworth St, Westfield, MA 01085-2212 | Controlled Substance Registration for Practitioner | 2011-05-31 ~ 2013-02-28 |
| Clive L Hamilton Dds | 585 Ellsworth St Apt 4m, Bridgeport, CT 06605-2525 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Iqbal Hussain | 550 Ellsworth Ave, New Haven, CT 06511-1632 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Bernardo M C Rodrigues | 78 Ellsworth Lane, Canton, CT 06019 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mina R Rasoulpour Md | 8 Ellsworth Rd, West Hartford, CT 06107 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
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| 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).