MARISSA DE FREESE (Credential# 894721) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
MARISSA DE FREESE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0046520. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 29 Hospital Plaza, Stamford, CT 06902. The current status is lapsed.
| Licensee Name | MARISSA DE FREESE |
| Credential ID | 894721 |
| Credential Number | CSP.0046520 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
29 Hospital Plaza Stamford CT 06902 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2009-09-25 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 565498 | 1.047916 | Physician/Surgeon | 2009-07-02 | 2018-01-01 - 2018-12-31 | INACTIVE |
| Street Address | 29 HOSPITAL PLAZA |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael A. Bernstein Md | 29 Hospital Plaza, Stamford, CT 06902 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Sandhya Dhruvakumar | 29 Hospital Plaza, Stamford, CT 06902-3733 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Gary S. Besser | 29 Hospital Plaza, Stamford, CT 06902-3633 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| George E Heading | 29 Hospital Plaza, Stamford, CT 06902 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| David K Hahn | 29 Hospital Plaza, Stamford, CT 06902-3661 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Asha K Shah | 29 Hospital Plaza, Stamford, CT 06902-3661 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Scott R Martin | 29 Hospital Plaza, Stamford, CT 06902 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael I Ebright | 29 Hospital Plaza, Stamford, CT 06902 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael A Coady | 29 Hospital Plaza, Stamford, CT 06902-2594 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Caroline M Gulati | 29 Hospital Plaza, Stamford, CT 06902 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeris Maydeli Flores | 153 Fairfield Av, Stamford, CT 06902 | Nail Technician | ~ |
| Reynaldo De La Cruz | 64 Brookside Drive, Stamford, CT 06902 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Darren J Petillo | 5 Hundley Court, Stamford, CT 06902 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Antonios Restaurant | 405 West Main St, Stamford, CT 06902 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Edward Smith | 184 Fairfield Ave., Stamford, CT 06902 | Home Improvement Contractor | ~ |
| Margaret A Dorrance | 24c Hamilton Court, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carolyn Maguire | 48 Nelson St, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Evelyne Joassin | 17 George St., Stamford, CT 06902 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Andrea Bynoe | 34 Melrose Pl, Stamford, CT 06902 | Notary Public Appointment | 1994-04-06 ~ 1999-04-30 |
| Ravi K Ahuja | 296 Westover Rd, Stamford, CT 06902 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06902 | |||
| City | STAMFORD |
| Zip Code | 06902 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + STAMFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marissa D Foster | 835 Mix Ave #411, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Marissa L Lahaie | 46 Hobbs Rd, Lee, NH 03861 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa M Lavin | 38 Elder St, Milford, CT 06460-6464 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa C Bayerl | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa Van Hennik Pa | 287 S Main St, Wallingford, CT 06492-4602 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa Tennant | 365 Montauk Ave, New London, CT 06320 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa L Stankus | 244 Parklawn Dr, Waterbury, CT 06708-2349 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa M Smith | 443 Wendell Terrace, Syracuse, NY 13203 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa A Novack | 120 Morgan St Apt 401b, Stamford, CT 06905-5438 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa A Schwartz | 44 Oakwood Ave, West Hartford, CT 06119-2175 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).