MICHAEL J FORTIN (Credential# 150470) 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.
MICHAEL J FORTIN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0013441. 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 25 Mohawk St, Middletown, CT 06457-3534. The current status is active.
| Licensee Name | MICHAEL J FORTIN |
| Credential ID | 150470 |
| Credential Number | CSP.0013441 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
25 Mohawk St Middletown CT 06457-3534 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-09 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 546160 | 1.026737 | Physician/Surgeon | 1985-08-20 | 2019-12-01 - 2020-11-30 | ACTIVE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael J Fortin | 184 Romanock Rd, Fairfield, CT 06825-7234 | Physical Therapist | 2019-12-01 ~ 2020-11-30 |
| Michael J Fortin | 51 Kent Stre, Danielson, CT 06239 | Hairdresser/cosmetician | 2020-01-01 ~ 2021-12-31 |
| Street Address | 25 MOHAWK ST |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-3534 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Doreen Mayhew | 15 Mohawk St, Middletown, CT 06457-3534 | Family Child Care Home | 2016-11-01 ~ 2020-10-31 |
| Francis L Mayhew | 15 Mohawk St, Middletown, CT 06457-3534 | Family Child Care Substitute | 2018-08-15 ~ 2020-08-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth M Mailhot | 177 Timber Ridge Rd, Middletown, CT 06457 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Rebecca S Fennessy | 22 Keefe Ln, Middletown, CT 06457 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Eloise M Gagnon | 538 Bow Lane, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Salvatore Dimauro | 245 Dekoven Dr, Middletown, CT 06457 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Frank L Wright | 261 Spencer Dr, Middletown, CT 06457 | Barber | 2020-08-01 ~ 2022-07-31 |
| Gino A Cardella | 50 Sonoma Lane, Middletown, CT 06457 | Real Estate Salesperson | ~ |
| Shannon Lee Mcquillan | 5 Forest Glen Circle, Middletown, CT 06457 | Registered Nurse | 2020-06-26 ~ 2020-09-30 |
| Lori Dimauro · Carta | 244 Chamberlain Hill Road, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Gail A Corrow | 85 Dora Dr, Middletown, CT 06457 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Mariter V Perez | 8 Moss Glen, Middletown, CT 06457 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06457 | |||
| City | MIDDLETOWN |
| Zip Code | 06457 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MIDDLETOWN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lynn Fortin Dvm | 177 Day Street, Newington, CT 06111 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Auguste H Fortin Vi | Yale New Haven Hospital, St. Raphael Campus, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Stacey C Michael Dmd | Michael Dental of Clinton, LLC, Clilnton, CT 06413 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael K Hwang Dmd | Michael K Hwang, Dmd, LLC, East Hartford, CT 06108 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael Murphy Md | P O Box 484, Danbury, CT 06813 | Controlled Substance Registration for Practitioner | 1996-09-18 ~ 1998-02-28 |
| Michael D Stangler | Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael B Schwartz | 30 Pin Oak Cir, Stamford, CT 06903-2828 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael M Talty Pa | Wingdale, NY 12594 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Michael J Lim | 300 Seaside Ave, Milford, CT 06460 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael Yao | 132 Bell Rd, Scarsdale, NY 10583-5835 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
Please comment or provide details below to improve the information on MICHAEL J FORTIN.
| 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).