B GEOFFREY BURNHAM PA (Credential# 164475) 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.
B GEOFFREY BURNHAM PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0021433. 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 19 Greentree Drive, Waterford, CT 06385. The current status is active.
| Licensee Name | B GEOFFREY BURNHAM PA |
| Credential ID | 164475 |
| Credential Number | CSP.0021433 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
19 Greentree Drive Waterford CT 06385 |
| 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 |
|---|---|---|---|---|---|
| 741829 | 23.000080 | Physician Assistant | 1993-08-13 | 2019-10-01 - 2020-09-30 | ACTIVE |
| Street Address | 19 GREENTREE DRIVE |
| City | WATERFORD |
| State | CT |
| Zip Code | 06385 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Karen R Weiss | 19 Greentree Drive, Waterford, CT 06385 | Registered Sanitarian | 2020-05-01 ~ 2021-04-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Howard Christopher Rosas | 40 Ridgewood Ave, Waterford, CT 06385 | Chiropractor | 2020-07-01 ~ 2021-06-30 |
| Vincent F Donato | 26 Wild Rose Avenue, Waterford, CT 06385 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Mark A Herter | 51 Quarry Rd, Waterford, CT 06385 | Architect | 2020-08-01 ~ 2021-07-31 |
| Pamela A Manke | 54 Rope Ferry Rd., Waterford, CT 06385 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Carol Winslow | 18 Myrock Ave, Waterford, CT 06385 | Marital and Family Therapist | 2020-09-01 ~ 2021-08-31 |
| Donna M Rivero · Knupp | 3 Ridgewood Ave, Waterford, CT 06385 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Margaret A Goldschneider · Chapman | 3 High Ridge Drive, Waterford, CT 06385 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Frank R Dellacono Md | 201 Boston Post Road, Waterford, CT 06385 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mathew H Tellier | 25 Locust Ct., Waterford, CT 06385 | Backflow Prevention Device Tester | 2020-06-18 ~ 2023-03-31 |
| Renata Kamburi | 16 Marilyn Road, Waterford, CT 06385 | Esthetician | 2020-06-20 ~ 2021-12-31 |
| Find all Licenses in zip 06385 | |||
| City | WATERFORD |
| Zip Code | 06385 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WATERFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Geoffrey Frattini Dvm | 96 Spring St, Cheshire, CT 06410 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Geoffrey E Ferrucci Pa | 69 Oak Leaf Dr, Waterbury, CT 06708 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Geoffrey Tsaras | 267 Grant St, Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2004-10-21 ~ 2005-02-28 |
| Geoffrey P Robinson Pa | 975 Farmington Ave, Bristol, CT 06010 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Geoffrey Miller Md | 333 Cedar St, New Haven, CT 06520-8064 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Geoffrey M Coley Md | 16 Charter Oak Pl, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Geoffrey R. Connors | 55 Wilkins Street, Hamden, CT 06517 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Geoffrey Gladstein Md | 5520 Park Ave Ste M2-100, Trumbull, CT 06611-3466 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Geoffrey L Hayward | 99 E River Dr Fl 5, East Hartford, CT 06108-7301 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Geoffrey E Herter | 32 Ingham Hill Rd, Essex, CT 06426-1507 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on B GEOFFREY BURNHAM 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).