MARYANN E SMITH MD (Credential# 235080) 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.
MARYANN E SMITH MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0029606. 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 293 West Rd, Salem, CT 06420-3507. The current status is active.
| Licensee Name | MARYANN E SMITH MD |
| Credential ID | 235080 |
| Credential Number | CSP.0029606 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
293 West Rd Salem CT 06420-3507 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2000-05-25 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 556125 | 1.038536 | Physician/Surgeon | 2000-04-07 | 2020-02-01 - 2021-01-31 | ACTIVE |
| 855167 | 70.850299 | Emergency Medical Technician | 1985-02-01 | - 1994-03-31 | INACTIVE |
| Street Address | 293 WEST RD |
| City | SALEM |
| State | CT |
| Zip Code | 06420-3507 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Debra I Delorimiere | 322 Round Hill Road, Salem, CT 06420 | Real Estate Salesperson | ~ |
| Darci J Smith | 25 Salem Ridge Drive, Salem, CT 06420 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Pamela Minella | 135 Sullivan Rd., Salem, CT 06420 | Water Treatment Plant Operator - Class Iv | 2020-04-01 ~ 2023-03-31 |
| Alfreda Shapere · Bingham | 170 Darling Rd, Salem, CT 06420 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Paul A Pudimat Md | 61 Emerald Glen Lane, Salem, CT 06420 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Thomas J Butcher | 248 Norwich Road, Salem, CT 06420 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Destiny Faye Henkel | 65 Horse Pond Rd, Salem, CT 06420 | Master's Level Social Worker - Temporary Permit | 2020-06-12 ~ 2020-09-13 |
| Kevin R Fennell | 105 Witter Road, Salem, CT 06420 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Scott D Pellerin | 301 Rattlesnake Ledge Road, Salem, CT 06420 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Salem Prime Cuts Inc · John Fusaro Jr | 12 New London Rd, Salem, CT 06420 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06420 | |||
| City | SALEM |
| Zip Code | 06420 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SALEM |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Maryann L Udy | 576 Forest Rd, Northford, CT 06472-1485 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Maryann Mcdonough | 15 Northridge Dr, Newtown, CT 06470-1252 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Maryann Fenton Md | 23 Indian Brook Rd, Ashland, MA 01721 | Controlled Substance Registration for Practitioner | 1998-03-01 ~ 1999-02-28 |
| Maryann Amini | Department of Medicine, Waterbury, CT 06706 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Maryann Shea Md | 372 Brookline Avenue, Warwick, RI 02886 | Controlled Substance Registration for Practitioner | 2001-04-20 ~ 2002-02-28 |
| Maryann E Lehmann | 5 Brook Street, Darien, CT 06820 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Maryann G Couch | 221 Berkley Ave, Belle Mead, NJ 08502 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Maryann Barranca Aprn | 31 Old Farm Hill Rd, Newtown, NY 06470 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Maryann T Putman · Owen | 77 Quarry Dock Rd, Branford, CT 06405 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
| Maryann Koprek | 42 Farmington Chase Cres Unit 42, Farmington, CT 06032-3188 | Controlled Substance Registration for Practitioner | 2019-11-29 ~ 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).