ROGER S VAN DYKE MD
Controlled Substance Registration for Practitioner


Address: 4 Shaw's Cove, New London, CT 06320

ROGER S VAN DYKE MD (Credential# 152538) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2009. The license expiration date date is February 28, 2011. The license status is INACTIVE.

Business Overview

ROGER S VAN DYKE MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0010172. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2009. The expiration date is February 28, 2011. The business address is 4 Shaw's Cove, New London, CT 06320. The current status is inactive.

Basic Information

Licensee Name ROGER S VAN DYKE MD
Credential ID 152538
Credential Number CSP.0010172
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 4 Shaw's Cove
New London
CT 06320
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2009-03-01
Expiration Date 2011-02-28
Refresh Date 2013-03-07

Other licenses

ID Credential Code Credential Type Issue Term Status
544304 1.022816 Physician/Surgeon 1981-05-21 2008-11-24 - 2010-01-31 INACTIVE

Office Location

Street Address 4 SHAW'S COVE
City NEW LONDON
State CT
Zip Code 06320

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Francis J Mayeda 4 Shaw's Cove, New London, CT 06320 Physician/surgeon 2020-09-01 ~ 2021-08-31
Ross J Sanfilippo 4 Shaw's Cove, New London, CT 06320 Dental Anesthesia/conscious Sedation Permit 2020-07-01 ~ 2021-06-30
Teresa M Matyas 4 Shaw's Cove, New London, CT 06320 Dentist 2020-06-01 ~ 2021-05-31
Sarah B Asher 4 Shaw's Cove, New London, CT 06320 Physician Assistant 2002-06-20 ~ 2002-12-31
Tia P Andrighetti Lnm 4 Shaw's Cove, New London, CT 06320 Licensed Nurse Midwife 1999-02-08 ~ 2000-03-31
Optics Unlimited Inc 4 Shaw's Cove, New London, CT 06320 Optical Selling Permit 1997-06-30 ~ 1998-08-31

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Competitor

Search similar business entities

City NEW LONDON
Zip Code 06320
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW LONDON

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Roger N Fox 2 Gordon Place, Middletown, CT 06457 Controlled Substance Registration for Practitioner 2007-03-13 ~ 2008-02-29
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Roger E Schmid Md 159 Old Hall Rd, Woodstock, CT 06281 Controlled Substance Registration for Practitioner 1993-01-07 ~ 1995-02-01
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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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