LILLIAN RAE HARSTINE
Controlled Substance Registration for Practitioner


Address: 216 E Vicksburg St, Broken Arrow, OK 74011-3807

LILLIAN RAE HARSTINE (Credential# 1397305) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is January 11, 2017. The license expiration date date is February 28, 2019. The license status is INACTIVE.

Business Overview

LILLIAN RAE HARSTINE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0064556. The credential type is controlled substance registration for practitioner. The effective date is January 11, 2017. The expiration date is February 28, 2019. The business address is 216 E Vicksburg St, Broken Arrow, OK 74011-3807. The current status is inactive.

Basic Information

Licensee Name LILLIAN RAE HARSTINE
Credential ID 1397305
Credential Number CSP.0064556
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 216 E Vicksburg St
Broken Arrow
OK 74011-3807
Business Type INDIVIDUAL
Status INACTIVE - RETIRED
Issue Date 2017-01-11
Effective Date 2017-01-11
Expiration Date 2019-02-28
Refresh Date 2018-12-12

Other licenses

ID Credential Code Credential Type Issue Term Status
1392889 1.056060 Physician/Surgeon 2017-01-10 2017-01-10 - 2017-08-31 INACTIVE

Office Location

Street Address 216 E VICKSBURG ST
City BROKEN ARROW
State OK
Zip Code 74011-3807

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Kevin M Hasselman 6321 S Birch Ave, Broken Arrow, OK 74011 Engineer-in-training 2003-06-10 ~ 2013-06-10
Paul R Hoyt 6316 S Ash Ave, Broken Arrow, OK 74011 Fire Protection Unlimited Journeyperson ~
April L Kubitz 429 W. San Diego St., Broken Arrow, OK 74011 Radiographer 2005-01-21 ~ 2005-11-30
Robert E Olson Jr 304 East Glendale, Broken Arrow, OK 74011 Professional Engineer 2001-02-01 ~ 2002-01-31
Ronald O Crawford 305 S Jefferson St, Roanoke, VA 74011 Architect 1996-08-01 ~ 1997-07-31
Arthur L Shelton 4312 S Dogwood Ave, Broken Arrow, OK 74011-1524 Professional Engineer 2011-02-01 ~ 2012-01-31
Freedom Pharmaceuticals Inc 801 W New Orleans St, Broken Arrow, OK 74011-1844 Out of State Manufacturer of Drugs, Cosmetics & Medical Devices 2011-11-09 ~
Christopher A Harwell 2313 W Ocala St, Broken Arrow, OK 74011-4518 Professional Engineer ~
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Competitor

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City BROKEN ARROW
Zip Code 74011
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BROKEN ARROW

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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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