KRISTINE SUPPLE PA (Credential# 164150) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 2, 1999. The license expiration date date is February 28, 2000. The license status is INACTIVE.
KRISTINE SUPPLE PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0023182. The credential type is controlled substance registration for practitioner. The effective date is March 2, 1999. The expiration date is February 28, 2000. The business address is 71 Lake St, Hamden, CT 06517-2317. The current status is inactive.
| Licensee Name | KRISTINE SUPPLE PA |
| Credential ID | 164150 |
| Credential Number | CSP.0023182 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
71 Lake St Hamden CT 06517-2317 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 1999-03-02 |
| Expiration Date | 2000-02-28 |
| Refresh Date | 2009-01-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 742231 | 23.000482 | Physician Assistant | 1995-01-20 | 1998-12-21 - 1999-12-31 | INACTIVE |
| Street Address | 71 LAKE ST |
| City | HAMDEN |
| State | CT |
| Zip Code | 06517-2317 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Timothy J Freer | 33 Norris Street, Hamden, CT 06517 | Physical Therapist | 2020-09-01 ~ 2021-08-31 |
| Juan Ignacio Zurita-castilla | 43 Merritt St, Hamden, CT 06517 | Master's Level Social Worker - Temporary Permit | 2020-06-25 ~ 2020-09-13 |
| Elizabeth Alberico | 58 Hesse Road, Hamden, CT 06517 | Notary Public Appointment | 2020-06-01 ~ 2025-05-31 |
| Stephen M Grossman | 17 Greenway St, Hamden, CT 06517 | Architect | 2020-08-01 ~ 2021-07-31 |
| James E Laposta Jr | 66 Laurel Road, Hamden, CT 06517 | Architect | 2020-08-01 ~ 2021-07-31 |
| Judith M Rothstein | 11 Dadio Road, Hamden, CT 06517 | Licensed Alcohol and Drug Counselor | 2020-04-01 ~ 2021-03-31 |
| Keleann T Tamaki | 165 Ridge Road, Hamden, CT 06517 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Robin L Esposito | 191 Thornton St, Hamden, CT 06517 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Michele R Abrams | 114 Wakefield St, Hamden, CT 06517 | Audiologist | 2020-09-01 ~ 2021-08-31 |
| Catherine E Tesluk | 215 Hartford Tpke, Hamden, CT 06517 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06517 | |||
| City | HAMDEN |
| Zip Code | 06517 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + HAMDEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kristine M Tingley | 15 Montclair Dr, Nashua, NH 03063-1329 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Kristine Welsh | P.o. Box 1105, Orange, CT 06477 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kristine Sp Hauser | 7 Reagan Ave, Franklin, MA 02038-3367 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kristine Kelliher | 85 Seymour St Ste 415, Hartford, CT 06106-5523 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kristine M Bessette | 80 Seymour St, Hartford, CT 06102-8000 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kristine M Treml Pa-c | 440 Meridn Rd #406, Waterbury, CT 06705 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Kristine M Callender | 71 Stoneheights Dr, Waterford, CT 06385-1936 | Controlled Substance Registration for Practitioner | 2019-11-12 ~ 2021-02-28 |
| Kristine M Smith | 7 Vintage Rd, Trumbull, CT 06611-1479 | Controlled Substance Registration for Practitioner | 2019-03-12 ~ 2021-02-28 |
| Kristine Macomber | 345 N Main St Ste 201, West Hartford, CT 06117-2508 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kristine M Drozd | 20 York Street, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).