LEONARD M LISIEN
Controlled Substance Registration for Practitioner


Address: 595 Main St, Portland, CT 06480

LEONARD M LISIEN (Credential# 149107) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 1999. The license expiration date date is February 28, 2000. The license status is INACTIVE.

Business Overview

LEONARD M LISIEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0008838. The credential type is controlled substance registration for practitioner. The effective date is March 1, 1999. The expiration date is February 28, 2000. The business address is 595 Main St, Portland, CT 06480. The current status is inactive.

Basic Information

Licensee Name LEONARD M LISIEN
Credential ID 149107
Credential Number CSP.0008838
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 595 Main St
Portland
CT 06480
Business Type INDIVIDUAL
Status INACTIVE - DOES NOT WISH TO RENEW
Effective Date 1999-03-01
Expiration Date 2000-02-28
Refresh Date 2004-04-23

Other licenses

ID Credential Code Credential Type Issue Term Status
701082 2.005589 Dentist 1979-06-16 1998-08-25 - 1999-08-31 INACTIVE

Office Location

Street Address 595 MAIN ST
City PORTLAND
State CT
Zip Code 06480

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Competitor

Search similar business entities

City PORTLAND
Zip Code 06480
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PORTLAND

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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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