STEPHANIE L PEGLOW
Controlled Substance Registration for Practitioner


Address: 780 Summer St, Stamford, CT 06901

STEPHANIE L PEGLOW (Credential# 1214932) 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.

Business Overview

STEPHANIE L PEGLOW is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0056949. 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 780 Summer St, Stamford, CT 06901. The current status is lapsed.

Basic Information

Licensee Name STEPHANIE L PEGLOW
Credential ID 1214932
Credential Number CSP.0056949
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 780 Summer St
Stamford
CT 06901
Business Type INDIVIDUAL
Status LAPSED
Active 1
Issue Date 2014-04-15
Effective Date 2017-03-01
Expiration Date 2019-02-28
Refresh Date 2019-03-06

Other licenses

ID Credential Code Credential Type Issue Term Status
1203123 1.052909-DO Physician/Surgeon 2014-04-01 2017-04-01 - 2018-03-31 INACTIVE

Office Location

Street Address 780 summer st
City Stamford
State CT
Zip Code 06901

Licenses in the same location

Licensee Name Office Address Credential Effective / Expiration
Integrated Care Clinic 780 Summer St, Stamford, CT 06901-1089 Substance Abuse 2012-10-01 ~ 2014-09-30

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Competitor

Search similar business entities

City Stamford
Zip Code 06901
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Stamford

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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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