JACOB A VANDERWERFF MD
Controlled Substance Registration for Practitioner


Address: 401 State St Unit M402, Portsmouth, NH 03801

JACOB A VANDERWERFF MD (Credential# 152537) 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

JACOB A VANDERWERFF MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0002500. 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 401 State St Unit M402, Portsmouth, NH 03801. The current status is inactive.

Basic Information

Licensee Name JACOB A VANDERWERFF MD
Credential ID 152537
Credential Number CSP.0002500
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 401 State St Unit M402
Portsmouth
NH 03801
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 1998-03-01
Expiration Date 1999-02-28
Refresh Date 2009-01-26

Office Location

Street Address 401 STATE ST UNIT M402
City PORTSMOUTH
State NH
Zip Code 03801

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Competitor

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City PORTSMOUTH
Zip Code 03801
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PORTSMOUTH

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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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