ETHAN A TAVERNA
Pharmacy Intern


Address: 12 Beths Rd, Shrewsbury, MA 01545-6900

ETHAN A TAVERNA (Credential# 1690783) is licensed (Pharmacy Intern) with Connecticut Department of Consumer Protection. The license effective date is September 16, 2019. The license expiration date date is September 30, 2023. The license status is ACTIVE.

Business Overview

ETHAN A TAVERNA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #PCI.0009419. The credential type is pharmacy intern. The effective date is September 16, 2019. The expiration date is September 30, 2023. The business address is 12 Beths Rd, Shrewsbury, MA 01545-6900. The current status is active.

Basic Information

Licensee Name ETHAN A TAVERNA
Credential ID 1690783
Credential Number PCI.0009419
Credential Type PHARMACY INTERN
Business Address 12 Beths Rd
Shrewsbury
MA 01545-6900
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2019-09-16
Effective Date 2019-09-16
Expiration Date 2023-09-30
Refresh Date 2019-09-19

Office Location

Street Address 12 BETHS RD
City SHREWSBURY
State MA
Zip Code 01545-6900

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Sara M Jaszczur 11 Turtle Creek Circle, Shrewsbury, MA 01545 Pharmacist 2020-02-01 ~ 2022-01-31
Michelle R Stumm 9 Sycamore Road, Shrewsbury, MA 01545 Registered Nurse 2020-08-01 ~ 2021-07-31
Mireya Wessolossky 9 Old Farm Circle, Shrewsbury, MA 01545 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
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Laura A Ames 9 Chartwell Circle, Shrewsbury, MA 01545 Nursing Home Administrator 2020-06-01 ~ 2022-05-31
Grisham M Bryan 30 Stonybrook Lane, Shrewsbury, MA 01545 Casino Class I Employee 2019-12-03 ~ 2020-10-31
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Competitor

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City SHREWSBURY
Zip Code 01545
License Type PHARMACY INTERN
License Type + County PHARMACY INTERN + SHREWSBURY

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Dataset Information

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).

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