JUSTIN C NGENE MD
Controlled Substance Registration for Practitioner


Address: 106 W Seeboth St, Milwaukee, WI 53204

JUSTIN C NGENE MD (Credential# 1028379) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 6, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.

Business Overview

JUSTIN C NGENE MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0051194. The credential type is controlled substance registration for practitioner. The effective date is March 6, 2015. The expiration date is February 28, 2017. The business address is 106 W Seeboth St, Milwaukee, WI 53204. The current status is inactive.

Basic Information

Licensee Name JUSTIN C NGENE MD
Credential ID 1028379
Credential Number CSP.0051194
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 106 W Seeboth St
Milwaukee
WI 53204
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2011-08-12
Effective Date 2015-03-06
Expiration Date 2017-02-28
Refresh Date 2018-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
999414 1.050207 Physician/Surgeon 2011-08-05 2014-08-01 - 2015-07-31 INACTIVE

Office Location

Street Address 106 W Seeboth st
City Milwaukee
State WI
Zip Code 53204

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Competitor

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City Milwaukee
Zip Code 53204
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Milwaukee

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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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