RENEE M PROVOST (Credential# 210688) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is December 28, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
RENEE M PROVOST is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0027986. The credential type is controlled substance registration for practitioner. The effective date is December 28, 2017. The expiration date is February 28, 2019. The business address is 25 Oak Lane, Bloomfield, CT 06002. The current status is lapsed.
| Licensee Name | RENEE M PROVOST |
| Credential ID | 210688 |
| Credential Number | CSP.0027986 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
25 Oak Lane Bloomfield CT 06002 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 1999-03-02 |
| Effective Date | 2017-12-28 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 680176 | 12.001998 | Advanced Practice Registered Nurse | 1999-01-08 | 2017-10-01 - 2018-09-30 | INACTIVE |
| 645006 | 10.R44219 | Registered Nurse | 1989-03-01 | 2017-10-01 - 2018-09-30 | INACTIVE |
| Street Address | 25 OAK LANE |
| City | BLOOMFIELD |
| State | CT |
| Zip Code | 06002 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paula L Raines | 92 Daniel Blvd, Bloomfield, CT 06002 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Kesone Taletia Telfer | 36 Walsh Street, Bloomfield, CT 06002 | Advanced Practice Registered Nurse | ~ |
| Joan Zito Upton | 106 Duncaster Road, Bloomfield, CT 06002 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Sheri M Sparks | Primary Eye Care Center, Bloomfield, CT 06002 | Optometrist | 2020-09-01 ~ 2021-08-31 |
| Kaman Aerospace Corporation | Old Windsor Road, Bloomfield, CT 06002 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Healing Meals Foundation Corporation | Po Box 7223, Bloomfield, CT 06002 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Taylor A West | 5 Tiffany Ln, Bloomfield, CT 06002 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Emma J Ranel | 53 Burr Road, Bloomfield, CT 06002 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Dorothy W Field | 177 Oliver Way, Bloomfield, CT 06002 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Carol J Mortensen | 6 Maple Edge Dr, Bloomfield, CT 06002 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06002 | |||
| City | BLOOMFIELD |
| Zip Code | 06002 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BLOOMFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Karin A Provost Do | 27 Randolph St, Wallingford, CT 06492 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Justin A Provost | 40 Prospect Ave Bldg1 Apt 4h, Norwalk, CT 06850-3737 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Renee E Hartshorn | 235 Hopmeadow St, Weatogue, CT 06089 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Renee Flores Md | 32 Pratt Ln, Wolcott, CT 06716-3013 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Renee Kim | 800 12th St Apt 701, Palisades Park, NJ 07650-2373 | Controlled Substance Registration for Practitioner | 2019-08-01 ~ 2021-02-28 |
| Renee K Derosa | 300 Meadow Rd, Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Renee S Kohanski | 3 Hospital Plz Ste 310, Old Bridge, NJ 08857-3095 | Controlled Substance Registration for Practitioner | 2019-04-05 ~ 2021-02-28 |
| Renee M Chin | 75 Wellington Rd, Elmont, NY 11003-1416 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Renee Flores Md | 56 Franklin St, Waterbury, CT 06706 | Controlled Substance Registration for Practitioner | ~ |
| Renee Simone | 71 Mary St, Chicopee, MA 01020-1139 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on RENEE M PROVOST.
| 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).