MICHELLE A BURGESS PA (Credential# 160564) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 1999. The license expiration date date is February 28, 2000. The license status is INACTIVE.
MICHELLE A BURGESS PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0027266. The credential type is controlled substance registration for practitioner. The effective date is March 1, 1999. The expiration date is February 28, 2000. The business address is 82 North Mountain Road, Sunderland, MA 01375. The current status is inactive.
| Licensee Name | MICHELLE A BURGESS PA |
| Doing Business As | MAIDEN NAME-DRAKE |
| Credential ID | 160564 |
| Credential Number | CSP.0027266 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
82 North Mountain Road Sunderland MA 01375 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 1999-03-01 |
| Expiration Date | 2000-02-28 |
| Refresh Date | 2009-01-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 742462 | 23.000713 | Physician Assistant | 1998-01-23 | 1998-07-16 - 1999-09-30 | INACTIVE |
| Street Address | 82 NORTH MOUNTAIN ROAD |
| City | SUNDERLAND |
| State | MA |
| Zip Code | 01375 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Evan Miller | 52 River Rd, Sunderland, MA 01375 | Tattoo Technician | 2020-02-28 ~ 2021-12-31 |
| Christine Sullivan | 91 North Plain Rd., Sunderland, MA 01375 | Registered Nurse | 2017-12-01 ~ 2018-11-30 |
| Corey W Cowdell | 117 No Plain Rd, Sunderland, MA 01375 | Pharmacy Intern | 2018-10-17 ~ 2022-09-30 |
| Joyce M Paciorek | 125 Russell St, Sunderland, MA 01375 | Real Estate Salesperson | 2005-06-01 ~ 2006-05-31 |
| Bruce R Weston | 113 North Main St, Sunderland, MA 01375 | Electrical Limited Journeyperson | 2004-10-01 ~ 2005-09-30 |
| Christopher A Connelly | 60 S Silver Ln, Sunderland, MA 01375 | Limited Sheet Metal Journeyperson | ~ |
| Carol A Claughton | 219 North Silver Lane, Sunderland, MA 01375 | Registered Nurse | 2012-07-01 ~ 2013-06-30 |
| Dorian Leigh Gregory | 215 N. Silver Lane, Sunderland, MA 01375 | Certified Public Accountant Certificate | ~ |
| Arthur T Haskell IIi | 14 South Plain Rd, Sunderland, MA 01375 | Electrical Limited Journeyperson | 2010-10-01 ~ 2011-09-30 |
| Jessica L Benjamin | Po Box 412/62 South Main St., Sunderland, MA 01375 | Radiographer | 2009-06-19 ~ 2010-08-31 |
| Find all Licenses in zip 01375 | |||
| City | SUNDERLAND |
| Zip Code | 01375 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SUNDERLAND |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Janice A Burgess Aprn | 9 Pulaski Hwy, Ansonia, CT 06401 | Controlled Substance Registration for Practitioner | 2009-04-21 ~ 2011-02-28 |
| Kelly Nichole Burgess Tull | 22 North Drive, Fiskdale, MA 01518 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Dennay Burgess | 263 Farmington Ave, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-08-12 ~ 2021-02-28 |
| Michelle L Allyn | 40 Rex Rd, Lisbon, CT 06351-2821 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michelle L Hershman | 865 Mix Ave Apt L4, New Haven, CT 06514-2143 | Controlled Substance Registration for Practitioner | 2013-07-02 ~ 2015-02-28 |
| Michelle A Van Name | 22 Acorn Dr, Bethany, CT 06524-3383 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lauren A Hai | 200 Michelle Ln Apt 303, Groton, CT 06340-4235 | Controlled Substance Registration for Practitioner | 2015-02-12 ~ 2017-02-28 |
| Michelle Wojciechowski | 915 N Franklin St, Tampa, FL 33602-3815 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michelle X Delneo | 373 Miner St, Middletown, CT 06457-8700 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Michelle Hure | 56 Franklin St, Waterbury, CT 06706 | Controlled Substance Registration for Practitioner | 2008-02-29 ~ 2009-02-28 |
Please comment or provide details below to improve the information on MICHELLE A BURGESS PA.
| 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).