JESSIE V PHILLIPS MD (Credential# 357331) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is April 7, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.
JESSIE V PHILLIPS MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0034384. The credential type is controlled substance registration for practitioner. The effective date is April 7, 2011. The expiration date is February 28, 2013. The business address is 300 Lucille Avenue, Elmont, NY 11003. The current status is inactive.
| Licensee Name | JESSIE V PHILLIPS MD |
| Credential ID | 357331 |
| Credential Number | CSP.0034384 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
300 Lucille Avenue Elmont NY 11003 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2005-04-15 |
| Effective Date | 2011-04-07 |
| Expiration Date | 2013-02-28 |
| Refresh Date | 2014-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 559629 | 1.042047 | Physician/Surgeon | 2003-12-10 | 2011-07-01 - 2012-06-30 | INACTIVE |
| Street Address | 300 Lucille Avenue |
| City | ELMONT |
| State | NY |
| Zip Code | 11003 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Martine Carol Boisrond | 1551 Lydia Avenue, Elmont, NY 11003 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Elizabeth T Thomas | 135 Diamond Street, Elmont, NY 11003 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Hardial Ramotar | 758 N. Ascan Street, Elmont, NY 11003 | Tax Preparer/facilitator Permit | 2020-02-11 ~ 2022-02-28 |
| Joan Beverley Barr | 782 Caroline Avenue, Elmont, NY 11003 | Tax Preparer/facilitator Permit | 2020-02-11 ~ 2022-02-28 |
| Claudette Patricia Hall | 75 Heathcote Rd, Elmont, NY 11003 | Master's Level Social Worker | 2020-01-01 ~ 2020-12-31 |
| Leroy G Brown | 77 Hathaway Ave, Elmont, NY 11003 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Charles Enoma | 2195 Hoffman Avenue, Elmont, NY 11003 | Master's Level Social Worker | 2018-10-01 ~ 2019-09-30 |
| Thomas J Cusack | Ten John Avenue, Elmont, NY 11003 | Notary Public Appointment | 1997-01-10 ~ 2002-01-31 |
| Rose Mai J. Pierre-louis Michel | 164 Locustwood Blvd, Elmont, NY 11003 | Master's Level Social Worker | 2019-08-01 ~ 2020-07-31 |
| Agena F Mondelice | 1505 Adele Ct, Elmont, NY 11003 | Registered Nurse | 2018-05-01 ~ 2019-04-30 |
| Find all Licenses in zip 11003 | |||
| City | ELMONT |
| Zip Code | 11003 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + ELMONT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jessie Dewanjee | 4 Nadia S Way, Farmington, CT 06032-1991 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jessie Gay | 1050 State St, New Haven, CT 06511-2762 | Controlled Substance Registration for Practitioner | 2019-08-13 ~ 2021-02-28 |
| Jessie Tijl Mangs | 298 Center St, Bristol, CT 06010-5021 | Controlled Substance Registration for Practitioner | 2019-01-23 ~ 2021-02-28 |
| Jessie Larson Md | 13 Rebecca Lane, Killingworth, CT 06419 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jessie E Brutus-darius Md | 2 Sierra Way, Danbury, CT 06810 | Controlled Substance Registration for Practitioner | 2003-03-01 ~ 2004-02-28 |
| Jessie Ellen Reisig | 111 Park Street, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Jessie M Moore Aprn | 1821 Little Meadow Rd, Guilford, CT 06437 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jessie C Long | 2028 Chapel Street, New Haven, CT 06515 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Jessie R Stasulis Dmd | 11 Golf Road, West Hartford, CT 06117 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jessie Marcoulier-gladu | 67 North Street, Granby, MA 01033 | 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).