JOAN DOBACK PA (Credential# 163122) 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.
JOAN DOBACK PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0021944. 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 57 Marbern Ln, Naugatuck, CT 06770-1613. The current status is active.
| Licensee Name | JOAN DOBACK PA |
| Credential ID | 163122 |
| Credential Number | CSP.0021944 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
57 Marbern Ln Naugatuck CT 06770-1613 |
| 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 | 2019-01-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 741916 | 23.000167 | Physician Assistant | 1993-10-08 | 2019-12-01 - 2020-11-30 | ACTIVE |
| Street Address | 57 MARBERN LN |
| City | NAUGATUCK |
| State | CT |
| Zip Code | 06770-1613 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Charles R Doback | 57 Marbern Ln, Naugatuck, CT 06770-1613 | Emergency Medical Technician | 2018-11-23 ~ 2021-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ryan T Hunt | 75 Marbern Ln, Naugatuck, CT 06770-1613 | Emergency Medical Technician | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mardiny Khvay | 152 Cherry St, Naugatuck, CT 06770 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-09-30 |
| Jennifer D Arsan-siemasko | 26 Seth Dr, Naugatuck, CT 06770 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Margaret R Berge | 375 May St, Naugatuck, CT 06770 | Master's Level Social Worker - Temporary Permit | 2020-06-26 ~ 2020-09-14 |
| Ilene Zayas | 38 Arch St., Naugatuck, CT 06770 | Medication Administration Certification | ~ |
| Paula M Coelho | 56 Jolie Road, Naugatuck, CT 06770 | Dental Hygienist | 2020-07-01 ~ 2021-06-30 |
| Shannen Grace Welz | 292 Spencer St, Naugatuck, CT 06770 | Esthetician | ~ |
| Tanjala M Samuels | 15 Lorann Circle, Naugatuck, CT 06770 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Andrea Lee Evans | 216 Spring Street Unit 17, Naugatuck, CT 06770 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jay Haack | 589 High Street, Naugatuck, CT 06770 | Medication Administration Certification | 2018-07-12 ~ 2020-07-11 |
| Kathleen B Chiarella | 67 Melbourne St, Naugatuck, CT 06770 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06770 | |||
| City | NAUGATUCK |
| Zip Code | 06770 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NAUGATUCK |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Joan Paul | 680 Mix Ave Apt 3p, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2009-10-19 ~ 2011-02-28 |
| Joan Cho Md | 55 Lock St, New Haven, CT 06511-3603 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Daniel Brein | 19 Joan Dr, Chappaqua, NY 10514-1414 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Joan Matyia Dvm | 46 Oak Lane Ext, Stonington, CT 06378 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Joan M Piccolo | 27 Godman Rd, Madison, CT 06443 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Joan P Palacios | 17 Acton St Apt 104, New Britain, CT 06053-2857 | Controlled Substance Registration for Practitioner | 2013-08-05 ~ 2015-02-28 |
| Joan M Landino | 147 Prince St, Wallingford, CT 06492-4139 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Joan Steinhardt Pa | 375 Glendale Ave Apt D-7, Bridgeport, CT 06606 | Controlled Substance Registration for Practitioner | 1993-08-02 ~ 1995-02-01 |
| Joan P Draper | 17 Cove Rd, Brookfield, CT 06804 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| M Joan Green | 372 Main St, Cromwell, CT 06416 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
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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).