CHRISTOPHER S MIRUCKI DMD
Controlled Substance Registration for Practitioner


Address: 19 Summit Rd, Wellesley, MA 02482-4656

CHRISTOPHER S MIRUCKI DMD (Credential# 1078724) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.

Business Overview

CHRISTOPHER S MIRUCKI DMD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0052740. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2013. The expiration date is February 28, 2015. The business address is 19 Summit Rd, Wellesley, MA 02482-4656. The current status is inactive.

Basic Information

Licensee Name CHRISTOPHER S MIRUCKI DMD
Credential ID 1078724
Credential Number CSP.0052740
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 19 Summit Rd
Wellesley
MA 02482-4656
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2012-06-25
Effective Date 2013-03-01
Expiration Date 2015-02-28
Refresh Date 2017-05-02

Other licenses

ID Credential Code Credential Type Issue Term Status
704182 2.009730 Dentist 2007-06-22 2013-06-01 - 2014-05-31 INACTIVE
449911 CSP.0040581 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2006-09-07 2009-03-01 - 2011-02-28 INACTIVE

Office Location

Street Address 19 SUMMIT RD
City WELLESLEY
State MA
Zip Code 02482-4656

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Competitor

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City WELLESLEY
Zip Code 02482
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WELLESLEY

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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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