MICHAEL JOHN GRILLE
Controlled Substance Registration for Practitioner


Address: 27 Christian Ln, Brookfield, CT 06804-3510

MICHAEL JOHN GRILLE (Credential# 1440515) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.

Business Overview

MICHAEL JOHN GRILLE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0066475. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 27 Christian Ln, Brookfield, CT 06804-3510. The current status is active.

Basic Information

Licensee Name MICHAEL JOHN GRILLE
Credential ID 1440515
Credential Number CSP.0066475
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 27 Christian Ln
Brookfield
CT 06804-3510
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2017-08-03
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2019-02-11

Other licenses

ID Credential Code Credential Type Issue Term Status
1426115 1.056807 Physician/Surgeon 2017-08-01 2019-09-01 - 2020-08-31 ACTIVE

Office Location

Street Address 27 CHRISTIAN LN
City BROOKFIELD
State CT
Zip Code 06804-3510

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Paul Fitzgerald 60 Old New Milford Rd., Brookfield, CT 06804-3510 Dentist 2019-07-01 ~ 2020-06-30
Audrey Vongsaroj 30 Christian Ln, Brookfield, CT 06804-3510 Pharmacy Technician 2011-04-01 ~ 2012-03-31

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Competitor

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City BROOKFIELD
Zip Code 06804
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BROOKFIELD

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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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