MARK RUSSI MD (Credential# 161478) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
MARK RUSSI MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0021550. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 5 Fraser Road, Westport, CT 06880. The current status is active.
| Licensee Name | MARK RUSSI MD |
| Credential ID | 161478 |
| Credential Number | CSP.0021550 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
5 Fraser Road Westport CT 06880 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-10 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 550199 | 1.032596 | Physician/Surgeon | 1992-09-04 | 2020-01-01 - 2020-12-31 | ACTIVE |
| Street Address | 5 FRASER ROAD |
| City | WESTPORT |
| State | CT |
| Zip Code | 06880 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Toni L Bucker | 4 Wild Rose Rd, Westport, CT 06880 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jee Hyun Kim | 1 Allen Lane, Westport, CT 06880 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2021-07-31 |
| Donna Vaccarella | 15 Keyser Rd, Westport, CT 06880 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Sandra Gibson | 12 Bayberry Ln, Westport, CT 06880 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Adil Salam Md | 44 Crawford Rd, Westport, CT 06880 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Joanne C Sosnoski | 24 Hawatha Lane, Westport, CT 06880 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Rachel Lynn | 495 Post Rd East, Westport, CT 06880 | Eyelash Technician | ~ |
| Beginnings: An Infant/toddler Program | 71 Hillandale Road, Westport, CT 06880 | Group Child Care Home | 2018-01-01 ~ 2021-12-31 |
| Shelley S Ross | 28 Old Hill Farms Rd, Westport, CT 06880 | Dietitian/nutritionist | 2020-08-01 ~ 2021-07-31 |
| Robert W Van Summern | 279 Wilton Rd, Westport, CT 06880 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06880 | |||
| City | WESTPORT |
| Zip Code | 06880 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WESTPORT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mark P Goldstein Md | 754 E 6th St #5d, New York, NY 10009 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark C Lee Md | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark R Cullen Md | 22 Lee Way, Madison, CT 06443 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Mark C Muetterties | 37 Bull St, Newport, RI 02840-2765 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark Coyle Pa | 4 Rockwood Rd, Medway, MA 02053 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark Youssef | 206 Spring St Apt #15, Naugatuck, CT 06770 | Controlled Substance Registration for Practitioner | 2015-07-09 ~ 2017-02-28 |
| Mark B Robel | 28 Greenway Rd, New London, CT 06320-5910 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark W Greve | 61 Three Corners Rd, Guilford, CT 06437 | Controlled Substance Registration for Practitioner | 2005-04-18 ~ 2006-02-28 |
| Mark Gorman | 333 Cedar St Lci 700, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Mark Brummitt Dvm | 24 Route 292, Patterson, NY 12563-2740 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
Please comment or provide details below to improve the information on MARK RUSSI MD.
| 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).