VITO L MODUGNO (Credential# 741702) is licensed (Dental Anesthesia/conscious Sedation Permit) with Connecticut Department of Consumer Protection. The license expiration date date is December 28, 1996. The license status is INACTIVE.
VITO L MODUGNO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #22.008150. The credential type is dental anesthesia/conscious sedation permit. The expiration date is December 28, 1996. The business address is 67 Village Lane, Wethersfield, CT 06109. The current status is inactive.
| Licensee Name | VITO L MODUGNO |
| Credential ID | 741702 |
| Credential Number | 22.008150 |
| Credential Type | Dental Anesthesia/Conscious Sedation Permit |
| Business Address |
67 Village Lane Wethersfield CT 06109 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1995-12-01 |
| Expiration Date | 1996-12-28 |
| Refresh Date | 2009-07-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 702615 | 2.008150 | Dentist | 1995-06-30 | - 1996-06-30 | INACTIVE |
| Street Address | 67 VILLAGE LANE |
| City | WETHERSFIELD |
| State | CT |
| Zip Code | 06109 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nishant Patel Md | 67 Village Lane, Wethersfield, CT 06109 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Darryl L Smith | 67 Village Lane, Wethersfield, CT 06109 | Respiratory Care Practitioner | 2002-08-05 ~ 2003-09-30 |
| Jennifer M Young | 67 Village Lane, Wethersfield, CT 06109 | Registered Nurse | 2000-10-10 ~ 2001-02-28 |
| Reza T Jalal Md | 67 Village Lane, Wethersfield, CT 06109 | Physician/surgeon | 1997-09-19 ~ 1998-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan E Dimauro | 330 Ridge Rd, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Mary Boccacio | 174 Longvue Drive, Wethersfield, CT 06109 | Esthetician | ~ |
| Steven C Hine | 294 Hang Dog Ln, Wethersfield, CT 06109 | Architect | 2020-08-01 ~ 2021-07-31 |
| Karolina Monika Fitrzyk | 41 Mountain Laurel, Wethersfield, CT 06109 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Matthew R Dobos | 33 Oxford St, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Samantha Grabbe | 17 Rockland St, Wethersfield, CT 06109 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Judith M Martz | 307 Nott Street, Wethersfield, CT 06109 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Ups Store (the) | 1077 Silas Deane Hwy, Wethersfield, CT 06109 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Amber H Washington | 103 Parkview Drive, Wethersfield, CT 06109 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Kathleen A Mullady · Brancati | 75 Dale Rd, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06109 | |||
| City | WETHERSFIELD |
| Zip Code | 06109 |
| License Type | Dental Anesthesia/Conscious Sedation Permit |
| License Type + County | Dental Anesthesia/Conscious Sedation Permit + WETHERSFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Carlos R Ibanez Md | School of Dental Medicine/omfs-l7073, Farmington, CT 06030 | Dental Anesthesia/conscious Sedation Permit | 2008-05-16 ~ 2009-06-30 |
| Andrew F Keene | 30 Currier Way, Cheshire, CT 06410-1468 | Dental Anesthesia/conscious Sedation Permit | 2020-05-01 ~ 2021-04-30 |
| Daniel J. Gill | 34 Dale Rd Ste 105, Avon, CT 06001-3659 | Dental Anesthesia/conscious Sedation Permit | 2020-09-01 ~ 2021-08-31 |
| David A Galbraith | 507 Hopmeadow St, Simsbury, CT 06070 | Dental Anesthesia/conscious Sedation Permit | 2020-05-01 ~ 2021-04-30 |
| Roger J Harris | 159 Ocean Ave, New London, CT 06320 | Dental Anesthesia/conscious Sedation Permit | 1997-05-27 ~ 1998-05-31 |
| Stephen S Rozen | 546 S Broad St Ste 2a, Meriden, CT 06450-6601 | Dental Anesthesia/conscious Sedation Permit | 2015-05-01 ~ 2016-04-30 |
| Donald J Case Dmd | 27 Bridge St, Stamford, CT 06905 | Dental Anesthesia/conscious Sedation Permit | 2020-05-01 ~ 2021-04-30 |
| Scott T Claiborne | 140 Huyshope Ave Apt 623, Hartford, CT 06106-2870 | Dental Anesthesia/conscious Sedation Permit | 2020-06-01 ~ 2021-05-31 |
| Stuart E Lieblich | 34 Dale Rd, Avon, CT 06001 | Dental Anesthesia/conscious Sedation Permit | 2020-05-01 ~ 2021-04-30 |
| Eric S Han | 697 Poquonock Avenue, Windsor, CT 06095 | Dental Anesthesia/conscious Sedation Permit | 2020-06-01 ~ 2021-05-31 |
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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).