MARYGENE M SANTA TERESA
Controlled Substance Registration for Practitioner


Address: 25 Thayer Ave, Narragansett, RI 02882-3819

MARYGENE M SANTA TERESA (Credential# 346385) 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.

Business Overview

MARYGENE M SANTA TERESA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0033866. 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 25 Thayer Ave, Narragansett, RI 02882-3819. The current status is active.

Basic Information

Licensee Name MARYGENE M SANTA TERESA
Credential ID 346385
Credential Number CSP.0033866
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 25 Thayer Ave
Narragansett
RI 02882-3819
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2003-07-29
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2019-02-28

Other licenses

ID Credential Code Credential Type Issue Term Status
559232 1.041649 Physician/Surgeon 2003-07-10 2019-12-01 - 2020-11-30 ACTIVE

Office Location

Street Address 25 THAYER AVE
City NARRAGANSETT
State RI
Zip Code 02882-3819

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Competitor

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City NARRAGANSETT
Zip Code 02882
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NARRAGANSETT

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Dataset Information

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).

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