DIANA M CICCHIELLO DMD
Dentist


Address: 42 N Main St#62, West Hartford, CT 06102

DIANA M CICCHIELLO DMD (Credential# 704065) is licensed (Dentist) with Connecticut Department of Consumer Protection. The license effective date is November 28, 2007. The license expiration date date is January 31, 2009. The license status is INACTIVE.

Business Overview

DIANA M CICCHIELLO DMD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #2.009613. The credential type is dentist. The effective date is November 28, 2007. The expiration date is January 31, 2009. The business address is 42 N Main St#62, West Hartford, CT 06102. The current status is inactive.

Basic Information

Licensee Name DIANA M CICCHIELLO DMD
Credential ID 704065
Credential Number 2.009613
Credential Type Dentist
Business Address 42 N Main St#62
West Hartford
CT 06102
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2006-06-27
Effective Date 2007-11-28
Expiration Date 2009-01-31
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
414861 CSP.0038235 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2005-09-28 2007-03-01 - 2008-02-29 INACTIVE

Office Location

Street Address 42 N MAIN ST#62
City WEST HARTFORD
State CT
Zip Code 06102

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Erica S Hammer 85 Jefferson Ave Ste 625, Hartford, CT 06102 Physician/surgeon 2020-07-01 ~ 2021-06-30
Joseph A Digiuseppe Dept of Pathology, Hartford, CT 06102 Physician/surgeon 2020-09-01 ~ 2021-08-31
Joseph V Portereiko Do Hartford Hospital : Department of Surgery, Hartford, CT 06102 Physician/surgeon 2020-07-01 ~ 2021-06-30
Vasanthy Thevarajah Hardfort Hospital, Hartford, CT 06102 Physician/surgeon 2020-06-01 ~ 2021-05-31
Elaine Manson 135 Dapex, Hartford, CT 06102 Medication Administration Certification ~
Valridine Durrant 2718 Main St, Hartford, CT 06102 Medication Administration Certification 2020-03-08 ~ 2022-03-07
Jennifer Susan Thran 80 Seymore St, Hartford, CT 06102 Registered Nurse ~
Monique M Vaughan 401 Granby Street, Hartford, CT 06102 Real Estate Salesperson ~
Bruce M Kaplan Md Hartford Hospital Gray Cancer Center, Hartford, CT 06102 Physician/surgeon 2020-03-01 ~ 2021-02-28
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Competitor

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City WEST HARTFORD
Zip Code 06102
License Type Dentist
License Type + County Dentist + WEST HARTFORD

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Dataset Information

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).

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