SUSAN W MARLATT MD (Credential# 219427) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
SUSAN W MARLATT MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0028671. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 32 Montgomery Parkway, Branford, CT 06405. The current status is active.
| Licensee Name | SUSAN W MARLATT MD |
| Credential ID | 219427 |
| Credential Number | CSP.0028671 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
32 Montgomery Parkway Branford CT 06405 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-08-12 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 548476 | 1.030466 | Physician/Surgeon | 1989-11-24 | 2019-10-01 - 2020-09-30 | ACTIVE |
| Street Address | 32 MONTGOMERY PARKWAY |
| City | BRANFORD |
| State | CT |
| Zip Code | 06405 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Raymond M Johnson | 39 Bayberry Lane, Branford, CT 06405 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kirsten M Ranciato | 288 East Main Street, Branford, CT 06405 | Licensed Clinical Social Worker | 2020-08-01 ~ 2021-07-31 |
| Bimala Khadka Thapa | 726 Robert Frost Dr., Branford, CT 06405 | Nail Technician | ~ |
| Paul E Basile | 42 Valley Brook Road South, Branford, CT 06405 | Perfusionist | 2020-08-01 ~ 2021-07-31 |
| Lupe Monica Placencia-muy | 100 East Main Street 2nd Fl, Branford, CT 06405 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-02-28 |
| Bridget J Jennings | 159 Queach Road, Branford, CT 06405 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Ujeli Acharya | 21 Burban Drive, Branford, CT 06405 | Nail Technician | ~ |
| Cathleen Smith | 50 First Avenue, Branford, CT 06405 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Gita Thapa | 94 Village Lane, Branford, CT 06405 | Nail Technician | ~ |
| Cycle Venture Partners Fund I Lp - Lumeda Series 1 | 50 Limewood Avenue, Branford, CT 06405 | Securities - Exemptions | 2020-06-17 ~ |
| Find all Licenses in zip 06405 | |||
| City | BRANFORD |
| Zip Code | 06405 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRANFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan Park Md | 1 Theall Rd, Rye, NY 10580 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Susan J Lee | 111 Park St Apt 14e, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2004-09-14 ~ 2005-02-28 |
| Susan P May | 40 Tunxis Vlg, Farmington, CT 06032-1518 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Susan B Kohn | 232 Second Rd, Summertown, TN 38483-8019 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Susan M Gamble | 64 Robbins St, Waterbury, CT 06708-2613 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Susan Maya | 198 Edwards St Apt 3, New Haven, CT 06511-3702 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Susan Cary | 12 Ruth Dr, Wilbraham, MA 01095-2610 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Susan B Cleary Dvm | 16 Tracy Cir, Amherst, MA 01002-3235 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Amy Susan Boudreau | 3 David St, Enfield, CT 06082-5033 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Susan Lee | 5606 Bissonnet St Apt 116, Houston, TX 77081-6131 | Controlled Substance Registration for Practitioner | 2019-10-24 ~ 2021-02-28 |
Please comment or provide details below to improve the information on SUSAN W MARLATT MD.
| 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).