KIMBERLY BEAULIEU (Credential# 162307) 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.
KIMBERLY BEAULIEU is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0023620. 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 98 Gardner Tavern Road, Coventry, CT 06238-6100. The current status is active.
| Licensee Name | KIMBERLY BEAULIEU |
| Credential ID | 162307 |
| Credential Number | CSP.0023620 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
98 Gardner Tavern Road Coventry CT 06238-6100 |
| 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 | 2019-01-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 741944 | 23.000195 | Physician Assistant | 1993-10-15 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 98 GARDNER TAVERN ROAD |
| City | COVENTRY |
| State | CT |
| Zip Code | 06238-6100 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Parul S Shah · Bidwell Spirit Shoppe | 1220 Main St, Coventry, CT 06238 | Package Store Liquor | 2020-08-02 ~ 2021-08-01 |
| Mary A Manton | 28 Armstrong Rd Unit B-9, Coventry, CT 06238 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Barbara J Dillon | 93 Alice Drive, Coventry, CT 06238 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Cody Adam Kirschbaum | 83 Daly Rd, Coventry, CT 06238 | Emergency Medical Technician | ~ |
| Stephanie A Simmons | 878 Silver St, Coventry, CT 06238 | Licensed Practical Nurse | 2020-02-01 ~ 2021-01-31 |
| Mellissa U Carroll | 349 Ripley Hill Rd, Coventry, CT 06238 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Kristin D'alfonso | 43 Windy Hill Road, Coventry, CT 06238 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Dawn Trudeau | 46 Flanders River Road, Coventry, CT 06238 | Medication Administration Certification | 2020-06-28 ~ 2022-06-27 |
| Bryan Trudel | 3505 South St., Coventry, CT 06238 | Backflow Prevention Device Tester | 2020-05-27 ~ 2023-03-31 |
| Christopher Dean | 545 Flanders Rd., Coventry, CT 06238 | Backflow Prevention Device Tester | 2020-05-27 ~ 2023-03-31 |
| Find all Licenses in zip 06238 | |||
| City | COVENTRY |
| Zip Code | 06238 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + COVENTRY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Danielle L Beaulieu | 121 Fenton Rd, Monson, MA 01057-9616 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jamie L Beaulieu | 51 Brettonwood Dr, Simsbury, CT 06070-1488 | Controlled Substance Registration for Practitioner | 2020-01-29 ~ 2021-02-28 |
| Mary C Beaulieu | 131 Boston Post Rd Ste 4, Waterford, CT 06385-2839 | Controlled Substance Registration for Practitioner | 2019-04-03 ~ 2021-02-28 |
| Brian L Beaulieu Md | Griffin Faculty Physicians, Derby, CT 06047 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kimberly A Keegan | 4 Den Rd, New Hartford, CT 06057-3502 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kimberly D Seifert | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-04-02 ~ 2021-02-28 |
| Kimberly F Lauth | 108 Church St Apt 406, New Haven, CT 06510-3008 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Kimberly W Keefe | 20 York St Tmp 209, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Kimberly J Kempner | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kimberly A George Pa | 88 Ridgefield Dr, Middletown, CT 06457-6540 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
Please comment or provide details below to improve the information on KIMBERLY BEAULIEU.
| 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).