KIMBERLY ELIZABETH BASTA (Credential# 2057097) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is June 19, 2020. The license expiration date date is February 28, 2021. The license status is APPROVED.
KIMBERLY ELIZABETH BASTA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0074554. The credential type is controlled substance registration for practitioner. The effective date is June 19, 2020. The expiration date is February 28, 2021. The business address is 3143 Edgemere Dr, Rochester, NY 14612-1123. The current status is approved.
| Licensee Name | KIMBERLY ELIZABETH BASTA |
| Credential ID | 2057097 |
| Credential Number | CSP.0074554 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
3143 Edgemere Dr Rochester NY 14612-1123 |
| Business Type | INDIVIDUAL |
| Status | APPROVED - CURRENT |
| Active | 1 |
| Issue Date | 2020-06-19 |
| Effective Date | 2020-06-19 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-06-19 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 2020644 | 12.008874 | Advanced Practice Registered Nurse | 2020-05-27 | 2020-05-27 - 2021-02-28 | ACTIVE |
| 1805892 | 10.169127 | Registered Nurse | 2020-03-05 | 2020-03-05 - 2021-02-28 | ACTIVE |
| Street Address | 3143 EDGEMERE DR |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14612-1123 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael Gerard Dunn | 820 Beach Avenue, Rochester, NY 14612 | Physician/surgeon | 2019-10-17 ~ 2020-09-30 |
| Debbie L Metzger Aprn | 170 North Church Rd, Rochester, NY 14612 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Carvel Corporation | 3177 Latta Rd, Rochester, NY 14612 | Frozen Dessert Wholesaler | 1996-03-01 ~ 1996-12-31 |
| W Gary Mccamy | 39 Tamarack St, Rochester, NY 14612 | Architect | 2017-02-06 ~ 2017-07-31 |
| John E Swink | 20 Delacorte Cir, Rochester, NY 14612 | Professional Engineer | 1800-12-27 ~ 1993-01-31 |
| Frederick J Noto | 1591 Latta Rd, Rochester, NY 14612 | Plumbing & Piping Unlimited Contractor | ~ |
| Courtney B. Sprung | 220 Emery Run, Rochester, NY 14612 | Dental Hygienist | 2012-10-01 ~ 2013-09-30 |
| Charles J Kirk | 3386 Edgemere Dr, Rochester, NY 14612 | Architect | 2006-12-21 ~ 2007-07-31 |
| David H Miles | 240 River Street, Rochester, NY 14612 | Lead Inspector | ~ 1998-07-31 |
| Kenneth W Johnson | 81 Pond View Hts., Rochester, NY 14612 | Asbestos Abatement Supervisor | 2001-01-19 ~ 2002-02-28 |
| Find all Licenses in zip 14612 | |||
| City | ROCHESTER |
| Zip Code | 14612 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + ROCHESTER |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrew W Basta Dmd | 1 Sheridan Ave, Congers, NY 10920 | Controlled Substance Registration for Practitioner | 2019-03-22 ~ 2021-02-28 |
| Yong-son Basta Md | 57 Hickok Rd, New Canaan, CT 06840 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda Elizabeth Magnoli | 15 Dearborn Dr, Cape Elizabeth, ME 04107-2302 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kimberly A Keegan | 4 Den Rd, New Hartford, CT 06057-3502 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kimberly A Kurey | 75 Cutler St, Stonington, CT 06378-1004 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kimberly A Bumbera | 187 Marion Ave, Plantsville, CT 06479-1442 | Controlled Substance Registration for Practitioner | 2019-04-25 ~ 2021-02-28 |
| Kimberly E Ellis | 105 Eastview Dr, Coventry, CT 06238-1678 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kimberly Gergelis | 1 Hospital Plz, Stamford, CT 06902-3602 | Controlled Substance Registration for Practitioner | 2018-03-21 ~ 2019-02-28 |
| Kimberly D Seifert | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-04-02 ~ 2021-02-28 |
| Kimberly Zeller Md | 8 Cottage St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2003-01-24 ~ 2004-02-28 |
Please comment or provide details below to improve the information on KIMBERLY ELIZABETH BASTA.
| 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).