RENZ J JUANEZA
Controlled Substance Registration for Practitioner


Address: 15 Walker Ln, Woodbridge, CT 06525-1627

RENZ J JUANEZA (Credential# 1242462) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.

Business Overview

RENZ J JUANEZA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0058623. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2015. The expiration date is February 28, 2017. The business address is 15 Walker Ln, Woodbridge, CT 06525-1627. The current status is inactive.

Basic Information

Licensee Name RENZ J JUANEZA
Credential ID 1242462
Credential Number CSP.0058623
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 15 Walker Ln
Woodbridge
CT 06525-1627
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2014-08-29
Effective Date 2015-03-01
Expiration Date 2017-02-28
Refresh Date 2018-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
1225985 1.053442 Physician/Surgeon 2014-08-11 2015-12-01 - 2016-11-30 INACTIVE

Office Location

Street Address 15 WALKER LN
City WOODBRIDGE
State CT
Zip Code 06525-1627

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Competitor

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City WOODBRIDGE
Zip Code 06525
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WOODBRIDGE

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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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