TRACY G CIVITILLO P.A. (Credential# 231862) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is July 31, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
TRACY G CIVITILLO P.A. is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0029263. The credential type is controlled substance registration for practitioner. The effective date is July 31, 2019. The expiration date is February 28, 2021. The business address is 71 Hickory Hill Rd, Simsbury, CT 06070. The current status is active.
| Licensee Name | TRACY G CIVITILLO P.A. |
| Credential ID | 231862 |
| Credential Number | CSP.0029263 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
71 Hickory Hill Rd Simsbury CT 06070 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2000-07-19 |
| Effective Date | 2019-07-31 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-08-01 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 742723 | 23.000974 | Physician Assistant | 2000-07-14 | 2019-12-01 - 2020-11-30 | ACTIVE |
| 756700 | 29.000292 | Massage Therapist | 1994-02-01 | 2016-12-01 - 2018-11-30 | INACTIVE |
| 870425 | 70.961411 | Emergency Medical Technician | 1996-07-24 | 2001-05-20 - 2003-03-31 | INACTIVE |
| Street Address | 71 HICKORY HILL RD |
| City | SIMSBURY |
| State | CT |
| Zip Code | 06070 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Henry Withers | 571 Hopmeadow St, Simsbury, CT 06070 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Nancy W Flanagan | 9 Carver Circle, Simsbury, CT 06070 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Catharina A Bates | 12 East View Dr., Simsbury, CT 06070 | Real Estate Salesperson | 2020-06-25 ~ 2021-05-31 |
| Faith E Preato | 25 Squadron Line Rd, Simsbury, CT 06070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Diane Bragoni | 542 Hopmeadow Street, #128, Simsbury, CT 06070 | Architect | 2020-08-01 ~ 2021-07-31 |
| Virginia S Durst · Banks | 20 Woodcliff Drive, Simsbury, CT 06070 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Caitlin M Cornier | 18 Saxton Brook Drive, Simsbury, CT 06070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Nancy L Alleva · Maule | 1079 Hopmeadow St, Simsbury, CT 06070 | Respiratory Care Practitioner | 2020-09-01 ~ 2021-08-31 |
| Stephen R Birghenti · Simsbury Inn | 397 Hopmeadow St, Simsbury, CT 06070 | Hotel Liquor (50000 Or More Population) | 2019-08-14 ~ 2020-12-13 |
| Deborah L Poniatowski · Blase | 35 Munnisunk Dr, Simsbury, CT 06070 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06070 | |||
| City | SIMSBURY |
| Zip Code | 06070 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SIMSBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Tracy E Kim Md | 178 Linden St Apt #g-4, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2003-03-01 ~ 2004-02-28 |
| Tracy L Johnson Dvm | 62 Grant Rd, Bethany, CT 06524-3063 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tracy L Macintosh | 23 Oxbow Dr, Meriden, CT 06450-6938 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Daniel W Tracy IIi | 100 Fanning Ave, Norwich, CT 06360 | Controlled Substance Registration for Practitioner | 2019-05-08 ~ 2021-02-28 |
| Tracy S Wang Md | 109 Church St Apt 401, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Tracy L Jones | 1 Peaceful Pl, Shelton, CT 06484-3418 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tracy Shevell Md | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tracy N. Huynh | 27 Hubinger St, New Haven, CT 06511-4034 | Controlled Substance Registration for Practitioner | 2011-06-28 ~ 2013-02-28 |
| Tracy C Kania | 231 Winding Rdg, Southington, CT 06489-2114 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tracy A Hawthorne Pa | 285 Turnpike Rd, Ashford, CT 06278-2411 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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| 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).