KATHLEEN M CHAISSON MD (Credential# 371028) 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.
KATHLEEN M CHAISSON MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0034939. 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 130 Division St # I, Derby, CT 06418-1326. The current status is active.
| Licensee Name | KATHLEEN M CHAISSON MD |
| Credential ID | 371028 |
| Credential Number | CSP.0034939 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
130 Division St # I Derby CT 06418-1326 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2004-05-24 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2018-12-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 559990 | 1.042408 | Physician/Surgeon | 2004-05-07 | 2020-02-01 - 2021-01-31 | ACTIVE |
| 857430 | 70.880737 | Emergency Medical Technician | 1988-06-01 | - 1997-06-30 | INACTIVE |
| Street Address | 130 Division St # I |
| City | DERBY |
| State | CT |
| Zip Code | 06418-1326 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ricardo Concepcion Gomez | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Turn The Tide Foundation Inc | 130 Division St Fl 2, Derby, CT 06418-1326 | Public Charity | 2017-12-01 ~ 2018-11-30 |
| Anwesh Poosala | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Genevieve C Kela | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Inshiya Dawoodi | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Sovit Dahal | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Rosa Constantino | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Ivanshi Gondalia | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Angad Gill | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Douglas Palacios | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Find all Licenses in zip 06418-1326 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Debra A Montini | 8 Academy Hill Ext, Derby, CT 06418 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Laura M Boanno | 131 Marshall La, Derby, CT 06418 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Danyun Chen | 49 Pershing Dr., Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Fan Geng | Shoprite Shopping Center, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Danni Xu | Shoprite Shopping Center49 Pershing Dr, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Yao Zhang | Shoprite Shopping Center 49 Pershing Dr, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Phillip N Burke | 3 Camptown St, Derby, CT 06418 | Emergency Medical Technician | 2017-06-07 ~ 2020-06-30 |
| Diane A Rosner | 229 Shagbark Drive, Derby, CT 06418 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Pamela C Lavelle | 194 Minerva St, Derby, CT 06418 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Grade A Market - Derby LLC | 49 Pershing Dr, Derby, CT 06418 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06418 | |||
| City | DERBY |
| Zip Code | 06418 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + DERBY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kathleen A. Ennis | 30 Orchard St, Cos Cob, CT 06807-2403 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kathleen M Thayer | P O Box 284, Colebrook, CT 06021 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Kathleen E Titus Pa | Po Box 650, Fiskdale, MA 01518 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Kathleen Thompson | 760 Mix Ave Apt 2e, Hamden, CT 06514-2210 | Controlled Substance Registration for Practitioner | 2019-11-15 ~ 2021-02-28 |
| Kathleen Moltz Md | 40 Second Ave #170, Waltham, MA 02154 | Controlled Substance Registration for Practitioner | 1995-12-12 ~ 1997-02-28 |
| Kathleen L Smith Md | Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Kathleen M Gabriele Do | 19 Woodland St Ste 31, Hartford, CT 06105-2335 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kathleen M Sanders | 435 Riverside Dr Apt 31, New York, NY 10025-7763 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Kathleen R Nurena Md | 90 Morgan St Ste 108, Stamford, CT 06905 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kathleen M D'orso | 483 Golf Rd, Orange, CT 06477-2117 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on KATHLEEN M CHAISSON 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).