JENNIFER L DODGE PA (Credential# 486495) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is April 16, 2009. The license expiration date date is February 28, 2011. The license status is INACTIVE.
JENNIFER L DODGE PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0042788. The credential type is controlled substance registration for practitioner. The effective date is April 16, 2009. The expiration date is February 28, 2011. The business address is 219 Route 164, Preston, CT 06365-8726. The current status is inactive.
| Licensee Name | JENNIFER L DODGE PA |
| Credential ID | 486495 |
| Credential Number | CSP.0042788 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
219 Route 164 Preston CT 06365-8726 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2007-10-31 |
| Effective Date | 2009-04-16 |
| Expiration Date | 2011-02-28 |
| Refresh Date | 2013-03-07 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 743749 | 23.002000 | Physician Assistant | 2007-10-17 | 2009-10-05 - 2010-06-30 | INACTIVE |
| Street Address | 219 ROUTE 164 |
| City | PRESTON |
| State | CT |
| Zip Code | 06365-8726 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Serena R Cochran | 219 Route 164, Preston, CT 06365-8726 | Dietitian/nutritionist | 2019-01-01 ~ 2019-12-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Karen Blackmer | 213 Route 164, Preston, CT 06365-8726 | Speech and Language Pathologist | 2020-03-01 ~ 2021-02-28 |
| Tracy L Rosiene | 211 Route 164, Preston, CT 06365-8726 | Massage Therapist | 2019-01-01 ~ 2020-12-31 |
| David W Hatch | 213 Route 164, Preston, CT 06365-8726 | Electrical Limited Journeyperson | 2019-10-01 ~ 2020-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Doggy Stylez Mobile Grooming · Doggy Stylez Mobile Grooming LLC | 5 Point St, Preston, CT 06365 | Grooming Facility | ~ |
| Mary A Oat- Pelletier · Oat | 66 River Road, Preston, CT 06365 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Lisa J Cooper | 43 Lincoln Park Rd, Preston, CT 06365 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Serena Tam | 6 Wilderness Acres Dr, Norwich, CT 06365 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Morell Apiaries LLC | 353 Rte# 165, Preston, CT 06365 | Food Manufacturing Establishment | 2020-07-01 ~ 2021-06-30 |
| Kendall M Gileau | 4 Brand Road, Preston, CT 06365 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Susan A Sampson | 17 Doolittle Rd, Preston, CT 06365 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Christopher P Jurczyk | 8 Puddleby Road, Preston, CT 06365 | Electrical Unlimited Contractor | 2020-05-28 ~ 2020-09-30 |
| Heather B Chaves | 97 Branch Hill Road, Preston, CT 06365 | Notary Public Appointment | 1996-04-18 ~ 2001-04-30 |
| Denyce Marie Martell | 19 Julian Dr, Preston, CT 06365 | Marital and Family Therapist | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06365 | |||
| City | PRESTON |
| Zip Code | 06365 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PRESTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John H Makari Md | 8200 Dodge St, Omaha, NE 68114-4113 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Richard J Powell | 41 Dodge Court, Guilford, CT 06437 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
| Tyanna Rn Barnes Crna | 155 Dodge Hill Rd, Sutton, MA 01590-2917 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Jordan H Kunkes | 18 Dodge Drive, West Hartford, CT 06107 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jennifer F Kherani | 2 Hughes Ave, Rye, NY 10580-1317 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2018-07-18 |
| Jennifer C Lee | 3 Gayridge Rd, Waterbury, CT 06705-3249 | Controlled Substance Registration for Practitioner | 2014-07-08 ~ 2015-02-28 |
| Jennifer Y Pan | 129 York St Apt 2g, New Haven, CT 06511-5640 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Jennifer K Leung Md | Stamford, CT 06902-6866 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Jennifer Y You Dmd | 921 State St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jennifer L Traxler | 137 E Elm St, Greenwich, CT 06830-6614 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
Please comment or provide details below to improve the information on JENNIFER L DODGE PA.
| 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).