MARK E PETHICK DMD (Credential# 51642) 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.
MARK E PETHICK DMD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0024894. 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 532 Chapel St, New Haven, CT 06511. The current status is active.
| Licensee Name | MARK E PETHICK DMD |
| Credential ID | 51642 |
| Credential Number | CSP.0024894 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
532 Chapel St New Haven CT 06511 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 702771 | 2.008311 | Dentist | 1996-10-11 | 2019-12-01 - 2020-11-30 | ACTIVE |
| Street Address | 532 CHAPEL ST |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Joseph D'ascanio Dmd | 532 Chapel St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Montessori School On Edgewood Inc. | 230 Edgewood Avenue, New Haven, CT 06511 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Therese Parks · Visel Drug Store | 264 Munson St, New Haven, CT 06511 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dazjia Monet Green | 115 Edgewood Ave Apt 64, New Haven, CT 06511 | Registered Nurse | 2020-06-27 ~ 2021-05-31 |
| Carol Yam | 343 Humphrey St, New Haven, CT 06511 | Registered Nurse | ~ |
| Marwan S Haddad | 38 Lincoln Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mary Lou Gaeta Md | 558 Chapel Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Cary M Tucker | 64 Bishop St, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Frank J Pannenborg | 505 Ellsworth Ave, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Crystal E Gooding | 26 Woodland Street, New Haven, CT 06511 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Kieran Jones | 260 Crown St Unit 1f, New Haven, CT 06511 | Registered Nurse | ~ |
| Find all Licenses in zip 06511 | |||
| City | NEW HAVEN |
| Zip Code | 06511 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mark R Cullen Md | 22 Lee Way, Madison, CT 06443 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Mark C Lee Md | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark P Goldstein Md | 754 E 6th St #5d, New York, NY 10009 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark Kimmel Md | 536 Saybrook Rd, Middletown, CT 06457 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Mark R Mercurio | 166 Pawson Rd, Branford, CT 06405-5012 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark Aferzon Md | 2 Ivy Brook Rd Ste 110, Shelton, CT 06484-6416 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark Waynik Md | 22 Winding Way, Trumbull, CT 06611-2945 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jon Mark Macnaughton | 100 Grand St, New Britain, CT 06052-2016 | Controlled Substance Registration for Practitioner | 2019-10-08 ~ 2021-02-28 |
| Mark Josel | 4 Northwestern Dr Ste 100, Bloomfield, CT 06002-3444 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Mark F Brady | 115 Dwight St Apt 4, New Haven, CT 06511-4580 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
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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).