AUDREY J BAKANAUSKAS APRN
Controlled Substance Registration for Practitioner


Address: 19 Phelps St, Windsor, CT 06075

AUDREY J BAKANAUSKAS APRN (Credential# 203566) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.

Business Overview

AUDREY J BAKANAUSKAS APRN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0027716. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2015. The expiration date is February 28, 2017. The business address is 19 Phelps St, Windsor, CT 06075. The current status is inactive.

Basic Information

Licensee Name AUDREY J BAKANAUSKAS APRN
Credential ID 203566
Credential Number CSP.0027716
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 19 Phelps St
Windsor
CT 06075
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2015-03-01
Expiration Date 2017-02-28
Refresh Date 2018-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
679817 12.001638 Advanced Practice Registered Nurse 1997-08-01 2016-03-01 - 2017-02-28 INACTIVE
653995 10.R54252 Registered Nurse 1997-06-13 2016-03-01 - 2017-02-28 INACTIVE

Office Location

Street Address 19 PHELPS ST
City WINDSOR
State CT
Zip Code 06075

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Normand E Cyr Park Street, Stafford, CT 06075 Notary Public Appointment 1958-01-28 ~ 1963-03-31
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James E Quinn 24 Bellrose St, Stafford, CT 06075 Notary Public Appointment 1960-02-01 ~ 1965-03-31
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Richard R Murray 71 East Street, Stafford, CT 06075 Notary Public Appointment 1961-08-01 ~ 1966-03-31
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Competitor

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City WINDSOR
Zip Code 06075
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WINDSOR

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Audrey L Elliott Dmd 4 Ichabod Rd, Simsbury, CT 06070 Controlled Substance Registration for Practitioner 2004-02-29 ~ 2005-02-28
Audrey M Kemp 8 Wildflower Drive, Hebron, CT 06248 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
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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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