ALIX REBECCA WILDER (Credential# 1805970) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is November 13, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
ALIX REBECCA WILDER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0072760. The credential type is controlled substance registration for practitioner. The effective date is November 13, 2019. The expiration date is February 28, 2021. The business address is 22 Berndale Dr, Westport, CT 06880-2745. The current status is active.
| Licensee Name | ALIX REBECCA WILDER |
| Credential ID | 1805970 |
| Credential Number | CSP.0072760 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
22 Berndale Dr Westport CT 06880-2745 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-11-13 |
| Effective Date | 2019-11-13 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-11-20 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1788428 | 12.008596 | Advanced Practice Registered Nurse | 2019-11-05 | 2019-11-05 - 2020-11-30 | ACTIVE |
| 1451223 | 10.147866 | Registered Nurse | 2018-01-25 | 2019-12-01 - 2020-11-30 | ACTIVE |
| 1453644 | 10.145314-TEMP | Registered Nurse - Temporary | 2017-09-29 | 2017-09-29 - 2018-01-26 | INACTIVE |
| Street Address | 22 BERNDALE DR |
| City | WESTPORT |
| State | CT |
| Zip Code | 06880-2745 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rachel G Polin | 22 Berndale Dr, Westport, CT 06880-2745 | Emergency Medical Technician | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Harold W Foodman | 34 Berndale Dr, Westport, CT 06880-2745 | Electrical Limited Contractor | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Toni L Bucker | 4 Wild Rose Rd, Westport, CT 06880 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jee Hyun Kim | 1 Allen Lane, Westport, CT 06880 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2021-07-31 |
| Donna Vaccarella | 15 Keyser Rd, Westport, CT 06880 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Sandra Gibson | 12 Bayberry Ln, Westport, CT 06880 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Adil Salam Md | 44 Crawford Rd, Westport, CT 06880 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Joanne C Sosnoski | 24 Hawatha Lane, Westport, CT 06880 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Rachel Lynn | 495 Post Rd East, Westport, CT 06880 | Eyelash Technician | ~ |
| Beginnings: An Infant/toddler Program | 71 Hillandale Road, Westport, CT 06880 | Group Child Care Home | 2018-01-01 ~ 2021-12-31 |
| Shelley S Ross | 28 Old Hill Farms Rd, Westport, CT 06880 | Dietitian/nutritionist | 2020-08-01 ~ 2021-07-31 |
| Robert W Van Summern | 279 Wilton Rd, Westport, CT 06880 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06880 | |||
| City | WESTPORT |
| Zip Code | 06880 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WESTPORT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Whitney Alix Young | 114 Woodland St, Hartford, CT 06105-1208 | Controlled Substance Registration for Practitioner | 2019-07-12 ~ 2021-02-28 |
| Alix J Tercius Md | 400 Coldspring Road, Rocky Hill, CT 06067 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Wilder Rucker | 1276 Dekalb Ave, Brooklyn, NY 11221-3204 | Controlled Substance Registration for Practitioner | ~ |
| Rebecca L West Md | 204 Crown St Apt 3, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Rebecca J Murray Dvm | 130 Saw Mill Rd, Branford, CT 06405 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Rebecca C Rastetter Md | 3 Finch Ln, Guilford, CT 06437-1092 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Rebecca E Hommer | 405 Reading Ave, Rockville, MD 20850-1520 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Rebecca A Keller | 230 Sunnyfield Dr, Windsor, CT 06095-3277 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Rebecca E Rosenberg | 67 Pearl St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Rebecca A Theise | 295 Humphrey St Fl 2, New Haven, CT 06511-3934 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
Please comment or provide details below to improve the information on ALIX REBECCA WILDER.
| 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).