JENNIFER T FORGASH
Controlled Substance Registration for Practitioner


Address: 89 Dove Ln, Middletown, CT 06457-6215

JENNIFER T FORGASH (Credential# 1360005) 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

JENNIFER T FORGASH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0063102. 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 89 Dove Ln, Middletown, CT 06457-6215. The current status is lapsed.

Basic Information

Licensee Name JENNIFER T FORGASH
Credential ID 1360005
Credential Number CSP.0063102
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 89 Dove Ln
Middletown
CT 06457-6215
Business Type INDIVIDUAL
Status LAPSED
Active 1
Issue Date 2016-06-11
Effective Date 2017-03-01
Expiration Date 2019-02-28
Refresh Date 2020-04-28

Other licenses

ID Credential Code Credential Type Issue Term Status
1356692 47.004190 Veterinarian 2016-06-09 2017-09-01 - 2018-08-31 INACTIVE

Office Location

Street Address 89 DOVE LN
City MIDDLETOWN
State CT
Zip Code 06457-6215

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Competitor

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City MIDDLETOWN
Zip Code 06457
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MIDDLETOWN

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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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