THEODORE BRUNO MD (Credential# 548193) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2019. The license expiration date date is November 30, 2020. The license status is ACTIVE.
THEODORE BRUNO MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.030049. The credential type is physician/surgeon. The effective date is December 1, 2019. The expiration date is November 30, 2020. The business address is 5 Tarry Town Lane, Niantic, CT 06357. The current status is active.
| Licensee Name | THEODORE BRUNO MD |
| Business Name | C/O KAISER PERMANENTE |
| Credential ID | 548193 |
| Credential Number | 1.030049 |
| Credential Type | Physician/Surgeon |
| Business Address |
5 Tarry Town Lane Niantic CT 06357 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1989-07-01 |
| Effective Date | 2019-12-01 |
| Expiration Date | 2020-11-30 |
| Refresh Date | 2019-12-16 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 159600 | CSP.0017314 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2011-03-01 - 2013-02-28 | INACTIVE |
| Street Address | 5 Tarry Town Lane |
| City | Niantic |
| State | CT |
| Zip Code | 06357 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Young Sun Kim | 265 Roxbury Rd, Niantic, CT 06357 | Nail Technician | ~ |
| Melissa B Bender | 9 Hoskins St, Niantic, CT 06357 | Veterinarian | 2020-07-01 ~ 2021-06-30 |
| Rachel Brennan | 8 Louise Drive, Niantic, CT 06357 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Tianhua Wang | 11 King Arthur Dr Unit 2h, Niantic, CT 06357 | Nail Technician | 2020-06-26 ~ 2022-02-28 |
| Maxwell V Nucci | 70 Smith St, Niantic, CT 06357 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Virada Lackey | 22 Sunnie Side Drive, Niantic, CT 06357 | Real Estate Salesperson | ~ |
| Niantic Cinema Corp | 279 Main St, Niantic, CT 06357 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Olivia M Blodgett | 30 Lake Ave, Niantic, CT 06357 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Katherine S Kleczkowski | P.o. Box 281, Niantic, CT 06357 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Robert W Cunningham | 9 South Rd., Niantic, CT 06357 | Distribution System Operator - Class II | 2020-04-01 ~ 2023-03-31 |
| Find all Licenses in zip 06357 | |||
| City | Niantic |
| Zip Code | 06357 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Niantic |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kaiser Permanente | 130 Hartford Rd, Manchester, CT 06040-5921 | Controlled Substance Registration for Practitioner | 2000-02-29 ~ 2001-02-28 |
| Kathryn M Palmer | Kaiser Permanente, Falls Church, VA 22046 | Physician/surgeon | 2009-05-08 ~ 2010-06-30 |
| Lucia S Whie-grayson | Kaiser Permanente, Downey, CA 90241 | Physician/surgeon | 1999-11-12 ~ 2001-01-31 |
| Kaiser Permanente | 299 Farmington Avenue, Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 1993-12-06 ~ 1995-12-01 |
| Kaiser Permanente Pharmacy 329 | 4131 Geary Blvd Ste 112, San Francisco, CA 94118-3101 | Nonresident Pharmacy | 2019-06-27 ~ 2020-08-31 |
| Kaiser Permanente Pharmacy #985 | 9521 Dalen St, Downey, CA 90242-4847 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Kaiser Permanente Wa Mail Order Pharmacy | 2921 Naches Ave Sw, Renton, WA 98057-2617 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Kaiser Permanente Sterling Automated Refill Center | 22370 Davis Dr, Sterling, VA 20164-5367 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Joe Marion Md | Kaiser Permanente, Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 2000-02-29 ~ 2001-02-28 |
| Suzie E Schuder Md · Kaiser Permanente | 780 Summer Street, Stamford, CT 06901 | Controlled Substance Registration for Practitioner | 1996-03-01 ~ 1997-02-28 |
Please comment or provide details below to improve the information on THEODORE BRUNO 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).