MAYA M PETASHNICK (Credential# 1654911) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is June 20, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
MAYA M PETASHNICK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0070848. The credential type is controlled substance registration for practitioner. The effective date is June 20, 2019. The expiration date is February 28, 2021. The business address is 263 Farmington Avenue, Farmington, CT 06030-1921. The current status is active.
| Licensee Name | MAYA M PETASHNICK |
| Credential ID | 1654911 |
| Credential Number | CSP.0070848 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
263 Farmington Avenue Farmington CT 06030-1921 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-06-20 |
| Effective Date | 2019-06-20 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-04-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1653230 | 1.062873-RES | Resident Physician | 2019-07-01 | 2019-07-01 - 2020-06-30 | ACTIVE |
| Street Address | 263 Farmington Avenue |
| City | Farmington |
| State | CT |
| Zip Code | 06030-1921 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Davis Aasen | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Christopher D Lemoine | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Dylan Buller | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Jennifer Lindelof | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Colin J Pavano | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Barrett B Torre | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Samantha Slattery | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Ethan A Miller | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-06-28 ~ 2024-06-30 |
| Patrick Bergamo | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-06-28 ~ 2024-06-30 |
| Shriya Gupta | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-06-28 ~ 2024-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Hady Eltayeby | 263 Farmington Avenue, Ct, Farmington, CT 06030-1921 | Controlled Substance Registration for Practitioner | ~ |
| Hassaan Aftab | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2019-07-01 ~ 2021-06-30 |
| Adriana Kahn | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-06-28 ~ 2021-06-30 |
| Shinya U. Amano | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2019-05-23 ~ 2019-06-06 |
| Mathur Prateek | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2019-01-02 ~ 2019-01-24 |
| Kenneth Aguirre | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-11-08 ~ 2018-11-17 |
| Nick M Feo | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-10-01 ~ 2018-10-14 |
| Rabeea Nazir | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-09-30 ~ 2018-10-13 |
| Jacob Jabbour | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-09-17 ~ 2018-09-28 |
| Natalie Godfrey | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-08-13 ~ 2018-08-24 |
| Find all Licenses in zip 06030-1921 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | Farmington |
| Zip Code | 06030 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Farmington |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan Maya | 198 Edwards St Apt 3, New Haven, CT 06511-3702 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Maya Arii | 239 Edwards St Apt 2e, New Haven, CT 06511-3736 | Controlled Substance Registration for Practitioner | 2010-09-16 ~ 2011-02-28 |
| Maya Salameh Md | 44 Pearl St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2004-03-23 ~ 2005-02-28 |
| Maya G Prabhu | C/o Law and Psychiatry Division, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Maya Johar Dds | 1354 Miller Pl, Los Angeles, CA 90069-1423 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Maya Bartel | 85 Laurel Road, Guilford, CT 06437-2350 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jose D. Herazo-maya | 24 Del Avenue, North Haven, CT 06473 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Maya T Khoukaz | 2312 Elliston Place Apt 441, Nashville, TN 37203 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Maya Corp | 9657 East Rush Street, South El Monte, CA 91733-1732 | Out of State Shipper Liquor | 1999-02-18 ~ 2000-02-17 |
| Maya Mae | Connecicut Brand Registration, Hartford, CT 06103 | Liquor Brand Label | 2017-11-09 ~ 2020-11-08 |
Please comment or provide details below to improve the information on MAYA M PETASHNICK.
| 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).