DONALD N BROMBACKER DDS
Controlled Substance Registration for Practitioner


Address: 470 Main St, Middlefield, CT 06455

DONALD N BROMBACKER DDS (Credential# 152688) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is April 12, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.

Business Overview

DONALD N BROMBACKER DDS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0004072. The credential type is controlled substance registration for practitioner. The effective date is April 12, 2013. The expiration date is February 28, 2015. The business address is 470 Main St, Middlefield, CT 06455. The current status is inactive.

Basic Information

Licensee Name DONALD N BROMBACKER DDS
Credential ID 152688
Credential Number CSP.0004072
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 470 Main St
Middlefield
CT 06455
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2004-10-20
Effective Date 2013-04-12
Expiration Date 2015-02-28
Refresh Date 2016-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
700501 2.004529 Dentist 1973-03-17 2013-05-01 - 2014-04-30 INACTIVE

Office Location

Street Address 470 MAIN ST
City MIDDLEFIELD
State CT
Zip Code 06455

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Competitor

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City MIDDLEFIELD
Zip Code 06455
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MIDDLEFIELD

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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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