ALAN WORTMAN DDS
Controlled Substance Registration for Practitioner


Address: 312 Main St, Southington, CT 06489

ALAN WORTMAN DDS (Credential# 151442) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 1998. The license expiration date date is February 28, 1999. The license status is INACTIVE.

Business Overview

ALAN WORTMAN DDS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0002527. The credential type is controlled substance registration for practitioner. The effective date is March 1, 1998. The expiration date is February 28, 1999. The business address is 312 Main St, Southington, CT 06489. The current status is inactive.

Basic Information

Licensee Name ALAN WORTMAN DDS
Credential ID 151442
Credential Number CSP.0002527
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 312 Main St
Southington
CT 06489
Business Type INDIVIDUAL
Status INACTIVE - DOES NOT WISH TO RENEW
Effective Date 1998-03-01
Expiration Date 1999-02-28
Refresh Date 2004-04-23

Other licenses

ID Credential Code Credential Type Issue Term Status
699967 2.003605 Dentist 1901-01-01 1997-10-27 - 1998-10-31 INACTIVE

Office Location

Street Address 312 MAIN ST
City SOUTHINGTON
State CT
Zip Code 06489

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Alexander M Clarke Od 312 Main St, Southington, CT 06489 Controlled Substance Registration for Practitioner 1998-03-01 ~ 1999-02-28

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Competitor

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City SOUTHINGTON
Zip Code 06489
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SOUTHINGTON

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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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