SAMANTHA KOZAKOWSKI (Credential# 1524095) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is June 22, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
SAMANTHA KOZAKOWSKI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0068693. The credential type is controlled substance registration for practitioner. The effective date is June 22, 2019. The expiration date is February 28, 2021. The business address is 1080a Farmington Ave, West Hartford, CT 06107-2115. The current status is active.
| Licensee Name | SAMANTHA KOZAKOWSKI |
| Credential ID | 1524095 |
| Credential Number | CSP.0068693 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1080a Farmington Ave West Hartford CT 06107-2115 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-07-09 |
| Effective Date | 2019-06-22 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-06-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1659640 | 2.012558 | Dentist | 2019-06-21 | 2019-08-01 - 2020-07-31 | ACTIVE |
| 1514541 | 2.012223-RES | Resident Dentist | 2018-06-25 | 2018-06-25 - 2019-06-24 | INACTIVE |
| Street Address | 1080A FARMINGTON AVE |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06107-2115 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Angela B Petrow | 1084a Farmington Ave, West Hartford, CT 06107-2115 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rebecca L Stansfield | 73 Tunxis Road, West Hartford, CT 06107 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Kumari Joshi | 44 Bentwood Rd, West Hartford, CT 06107 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Laurie C Caines Md | 205 Stoner Drive, West Hartford, CT 06107 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Nicole K. Edlund | 11 Greenacres Avenue, West Hartford, CT 06107 | Master's Level Social Worker - Temporary Permit | ~ |
| Andrea M Yuliano | 39 Mountain Terrace Road, West Hartford, CT 06107 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Elizabeth M Ineson | 4 Linwold Dr, West Htfd, CT 06107 | Architect | 2020-08-01 ~ 2021-07-31 |
| Sarah G Potter | 19 Westland Ave, West Hartford, CT 06107 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Jessica C Abreu | 14 Deepwood Lane, West Hartford, CT 06107 | Real Estate Salesperson | 2020-06-18 ~ 2021-05-31 |
| William C Richter | 67 Hillsboro Drive, West Hartford, CT 06107 | Architect | 2020-08-01 ~ 2021-07-31 |
| Teresa M Stanton | 25 Common Dr., West Hartford, CT 06107 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06107 | |||
| City | WEST HARTFORD |
| Zip Code | 06107 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WEST HARTFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Samantha A Matney | 33 Radding St, Manchester, CT 06042-3628 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Samantha Dane | 2 Stelmack Rd, Derby, CT 06418-2513 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Samantha S Hyacinth | 70-212 Scott St, Meriden, CT 06450-7242 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Samantha M Genovese | 3 Ric Ct, North Branford, CT 06471 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Samantha G Lee | 172 Whitman Ave, West Hartford, CT 06107-1635 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kent Huynh | 83 Samantha Circle, L4B2S1 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Samantha Wennerberg Pa | 55 Lock St, New Haven, CT 06511-3603 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Samantha K Mraz | 70 Ripton Rd, Shelton, CT 06484-2668 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Samantha A Pelow | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Samantha Dippolino | 577 High St, Middletown, CT 06457-2222 | Controlled Substance Registration for Practitioner | 2019-07-15 ~ 2021-02-28 |
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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).