DIANE SOUTHWORTH (Credential# 1548784) is licensed (Medication Administration Certification) with Connecticut Department of Consumer Protection. The license effective date is January 28, 2020. The license expiration date date is January 27, 2022. The license status is ACTIVE.
DIANE SOUTHWORTH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #DSMA.001706128. The credential type is medication administration certification. The effective date is January 28, 2020. The expiration date is January 27, 2022. The business address is 6 Pell Mell Drive, Bethel, CT 06801. The current status is active.
| Licensee Name | DIANE SOUTHWORTH |
| Credential ID | 1548784 |
| Credential Number | DSMA.001706128 |
| Credential Type | Medication Administration Certification |
| Business Address |
6 Pell Mell Drive Bethel CT 06801 |
| Business Type | EMPLOYEE ONLY |
| Status | ACTIVE - CERTIFIED |
| Active | 1 |
| Issue Date | 2015-12-05 |
| Effective Date | 2020-01-28 |
| Expiration Date | 2022-01-27 |
| Refresh Date | 2020-02-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1548889 | DSMA.001606128 | Medication Administration Certification | 2014-02-06 | 2016-01-28 - 2018-01-27 | INACTIVE |
| Street Address | 6 Pell Mell Drive |
| City | Bethel |
| State | CT |
| Zip Code | 06801 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John Anthony Dulko | 6 Winthrop Road, Bethel, CT 06801 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Antonietta Sproviero-metaxas | 36 Quaker Ridge Road, Bethel, CT 06801 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Mark K Roos | 6 Crestview Road, Bethel, CT 06801 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Susan Nguyen | 14b Cawley Ave., Bethel, CT 06801 | Esthetician | ~ |
| Blue Jay Orchards | 125 Plumtrees Rd, Bethel, CT 06801 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Varano Bakery | 198 Greenwood Ave, Bethel, CT 06801 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Nina M Kilcourse | 3 Bayberry Hill Rd, Bethel, CT 06801 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Ralph Ramsdell · Big Y | 83 Stony Hill Road, Bethel, CT 06801 | Grocery Beer | 2020-04-18 ~ 2021-04-17 |
| Marilu F Jeton | 36 Weed Rd, Bethel, CT 06801 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Petagay V Hewitt | 44 Greenwood Avenue, Bethel, CT 06801 | Real Estate Salesperson | ~ |
| Find all Licenses in zip 06801 | |||
| City | Bethel |
| Zip Code | 06801 |
| License Type | Medication Administration Certification |
| License Type + County | Medication Administration Certification + Bethel |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Trudy Southworth | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2003-04-28 ~ 2005-04-27 |
| Allison Southworth | 225 Commerce Drive, Canton, CT 06019-1099 | Medication Administration Certification | 1998-12-20 ~ 2000-12-19 |
| Diane Botelho | 857 Laurel Ave, Bridgeport, CT 06604 | Medication Administration Certification | ~ |
| Diane E Williams | P.o. Box 726, Bristol, CT 06011-0726 | Medication Administration Certification | 2017-12-16 ~ 2019-12-15 |
| Diane Bourgoin | P.o. Box 726, Bristol, CT 06011-0726 | Medication Administration Certification | 1991-10-30 ~ 1993-10-29 |
| Diane Robinson | 341 Sherman Ave., New Haven, CT 06511 | Medication Administration Certification | ~ |
| Diane Botelho | 851 Laurel Ave, Bridgeport, CT 06604 | Medication Administration Certification | ~ |
| Diane Higgins | Po Box 136, Poquonock, CT 06064 | Medication Administration Certification | 2019-11-09 ~ 2021-11-08 |
| Diane Latvis | P.o. Box 726, Bristol, CT 06011-0726 | Medication Administration Certification | 1993-11-07 ~ 1995-11-06 |
| Diane Tomecko | P.o. Box 185, So. Woodstock, CT 06267 | Medication Administration Certification | 2008-12-09 ~ 2010-12-08 |
Please comment or provide details below to improve the information on DIANE SOUTHWORTH.
| 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).