KAI PETTY-CHISHOLM (Credential# 1553610) is licensed (Medication Administration Certification) with Connecticut Department of Consumer Protection. The license effective date is October 22, 2014. The license expiration date date is October 21, 2016. The license status is INACTIVE.
KAI PETTY-CHISHOLM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #DSMA.001415022. The credential type is medication administration certification. The effective date is October 22, 2014. The expiration date is October 21, 2016. The business address is P.o. Box 872, Roselle Rm 230, Southbury, CT 06488. The current status is inactive.
| Licensee Name | KAI PETTY-CHISHOLM |
| Credential ID | 1553610 |
| Credential Number | DSMA.001415022 |
| Credential Type | Medication Administration Certification |
| Business Address |
P.o. Box 872, Roselle Rm 230 Southbury CT 06488 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2012-10-22 |
| Effective Date | 2014-10-22 |
| Expiration Date | 2016-10-21 |
| Refresh Date | 2018-08-01 |
| Street Address | P.O. Box 872, Roselle Rm 230 |
| City | Southbury |
| State | CT |
| Zip Code | 06488 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Pauline Whipple | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2018-10-01 ~ 2020-09-30 |
| Linda Renfro | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2018-09-23 ~ 2020-09-22 |
| Arthur Bernabucci | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2018-09-22 ~ 2020-09-21 |
| Samuel Cummings Sr | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2018-09-15 ~ 2020-09-14 |
| Jacqueline Gibson | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2018-09-14 ~ 2020-09-13 |
| Sandra Doughty | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2018-09-01 ~ 2020-08-31 |
| Hong Lee | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2018-08-30 ~ 2020-08-29 |
| Charles Cowan | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2018-08-29 ~ 2020-08-28 |
| Keona Leary | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2018-08-29 ~ 2020-08-28 |
| Michael Washington | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2018-08-29 ~ 2020-08-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jillian Jung | 582 Patriot Rd, Southbury, CT 06488 | Radiographer | 2020-08-01 ~ 2021-07-31 |
| Mary E Kohler | 201 Old Highway, Southbury, CT 06488 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Theresa K Bobak | 266b Heritage Village, Southbury, CT 06488 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Kelly Watson | 800 Main Street South Suite 102, Southbury, CT 06488 | Medication Administration Certification | 2018-06-27 ~ 2020-06-26 |
| Mcdonald's Rest #2104 | 44 Division St, Derby, CT 06488 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Shirley A Frager | 5 West View Rd, Southbury, CT 06488 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Maureen K Boyd | 77 Shane Drive, Southbury, CT 06488 | Physical Therapist | 2020-09-01 ~ 2021-08-31 |
| South Britain Oil LLC | 424 Old Field Rd, Southbury, CT 06488 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Won Ju Lee | 995 Old Field Rd, Southbury, CT 06488 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-01-31 |
| Mcdonald's Rest #27001 | 652 New Haven Ave, Derby, CT 06488 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06488 | |||
| City | Southbury |
| Zip Code | 06488 |
| License Type | Medication Administration Certification |
| License Type + County | Medication Administration Certification + Southbury |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Devon Petty | 129 Washington St., Waterbury, CT 06706 | Medication Administration Certification | ~ |
| Shannon Petty | 99 Newhall St, New Haven, CT 06511 | Medication Administration Certification | 2018-10-18 ~ 2020-10-17 |
| Linda Petty | 40 Broadway, Norwich, CT 06360 | Medication Administration Certification | 1991-01-18 ~ 1993-01-17 |
| John Chisholm | 122 Harlan St., Manchester, CT 06042 | Medication Administration Certification | 2020-01-08 ~ 2022-01-07 |
| Phillip Petty | 433 Boston Post Rd, Westbrook, CT 06498 | Medication Administration Certification | 2015-06-25 ~ 2017-06-24 |
| Tierra Petty | 120 Holcomb Street, Hartford, CT 06112-1589 | Medication Administration Certification | 2013-12-12 ~ 2015-12-11 |
| Catherine Petty | 200 Research Parkway, Meriden, CT 06450 | Medication Administration Certification | 2018-03-12 ~ 2020-03-11 |
| Bruce Petty Jr | 5 Jeffrey Dr., South Windsor, CT 06074 | Medication Administration Certification | 2015-11-25 ~ 2017-11-24 |
| Dejavon Chisholm | 38 Union Street, Manchester, CT 06042 | Medication Administration Certification | 2018-12-09 ~ 2020-12-08 |
| Maurice Chisholm | 295 Alvord Park Rd., Torrington, CT 06790-3468 | Medication Administration Certification | 2007-04-28 ~ 2009-04-27 |
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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).