DIANE WILLIS (Credential# 1564966) is licensed (Medication Administration Certification) with Connecticut Department of Consumer Protection. The license effective date is June 25, 2018. The license expiration date date is June 24, 2020. The license status is LAPSED.
DIANE WILLIS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #DSMA.001807422. The credential type is medication administration certification. The effective date is June 25, 2018. The expiration date is June 24, 2020. The business address is P.o. Box 872, Roselle Rm 230, Southbury, CT 06488. The current status is lapsed.
| Licensee Name | DIANE WILLIS |
| Credential ID | 1564966 |
| Credential Number | DSMA.001807422 |
| Credential Type | Medication Administration Certification |
| Business Address |
P.o. Box 872, Roselle Rm 230 Southbury CT 06488 |
| Business Type | EMPLOYEE ONLY |
| Status | LAPSED - LAPSED RENEWAL |
| Active | 1 |
| Issue Date | 2016-05-08 |
| Effective Date | 2018-06-25 |
| Expiration Date | 2020-06-24 |
| Refresh Date | 2020-06-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1534352 | DSMA.001607422 | Medication Administration Certification | 2014-04-23 | 2016-06-25 - 2018-06-24 | INACTIVE |
| 1534351 | DSMA.001407422 | Medication Administration Certification | 2012-05-10 | 2014-06-25 - 2016-06-24 | INACTIVE |
| 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 |
|---|---|---|---|
| Alex Willis | 35 Elm St., Naugatuck, CT 06770 | Medication Administration Certification | 2006-08-05 ~ 2008-08-04 |
| Dennis Cue | 90 Willis St., New Haven, CT 06511 | Medication Administration Certification | 2020-02-13 ~ 2022-02-13 |
| Betie Willis | 182 Wolfpit, Norwalk, CT 06851 | Medication Administration Certification | 1996-02-24 ~ 1998-02-23 |
| Mary Pomeroy | 78 Willis Ave, Meriden, CT 06450 | Medication Administration Certification | 2019-02-05 ~ 2021-02-05 |
| Nicholas Ware | 77 Willis St., New Haven, CT 06511 | Medication Administration Certification | 2019-12-05 ~ 2021-12-04 |
| Eric Willis | 84b Linwood Ave., Colchester, CT 06415 | Medication Administration Certification | 2014-10-18 ~ 2016-10-17 |
| Barbara Willis | 80 Whitney St., Hartford, CT 06105 | Medication Administration Certification | 2013-04-13 ~ 2015-04-12 |
| Carmel Willis | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2017-11-07 ~ 2019-11-06 |
| Donald Willis | 335 Hamilton Ave, Norwich, CT 06360 | Medication Administration Certification | 2019-06-06 ~ 2021-06-05 |
| Tanaysia Willis | 518 Ferry Street, New Haven, CT 06513 | Medication Administration Certification | ~ |
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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).