LESLIE A WAGENBERG MD (Credential# 159309) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is May 8, 2007. The license expiration date date is February 29, 2008. The license status is INACTIVE.
LESLIE A WAGENBERG MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0020144. The credential type is controlled substance registration for practitioner. The effective date is May 8, 2007. The expiration date is February 29, 2008. The business address is 5257 Ndcbu, Taos, NM 87571. The current status is inactive.
| Licensee Name | LESLIE A WAGENBERG MD |
| Credential ID | 159309 |
| Credential Number | CSP.0020144 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
5257 Ndcbu Taos NM 87571 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 2007-05-08 |
| Expiration Date | 2008-02-29 |
| Refresh Date | 2009-02-05 |
| Street Address | 5257 NDCBU |
| City | TAOS |
| State | NM |
| Zip Code | 87571 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Edward A Rodriguez | 1013 Witt Road, Taos, NM 87571 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Susan L Roberts · Mitchell | 8064 Ndcbu, Taos, NM 87571 | Registered Nurse | 2001-12-04 ~ 2002-12-31 |
| David K Sargert | 122 C Paseo Del Pueblo Sur, Taos, NM 87571 | Interior Designer | 2006-01-01 ~ 2006-12-31 |
| Nancy E Coppola | General Delivery, Taos, NM 87571 | Registered Nurse | 1998-01-30 ~ 1998-10-31 |
| Suzanne E Kiermont | Po Box 3671, Taos, NM 87571-3671 | Dental Hygienist | 2020-03-01 ~ 2021-02-28 |
| Leslie A Wagenberg-grella | 210 Siler Rd., Taos, NM 87571-6111 | Physician/surgeon | 2004-09-23 ~ 2005-09-30 |
| Lilly-marie M Blecher | 1331 Maestas Rd, Taos, NM 87571-6268 | Naturopathic Physician | 2019-12-01 ~ 2020-11-30 |
| City | TAOS |
| Zip Code | 87571 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + TAOS |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Leslie A Wagenberg-grella | 210 Siler Rd., Taos, NM 87571-6111 | Physician/surgeon | 2004-09-23 ~ 2005-09-30 |
| Leslie S Wu Md | 101 Orange St Apt 320, New Haven, CT 06510-3108 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Leslie S Dick Md | Po Box 315, Weatogue, CT 06089-0315 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Leslie B Lindenberg Md | 40 Dale Rd, Avon, CT 06001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Leslie Long Pa | 126 Filbert St, Hamden, CT 06517-1314 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Leslie P. Goldman | 461 E. Hyerdale Dr., Goshen, CT 06756 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Leslie Billington | 17 Dresser St, Newport, RI 02840-3620 | Controlled Substance Registration for Practitioner | 2018-03-15 ~ 2019-02-28 |
| Leslie N Brown | 23 Gateway Rd, Colchester, CT 06415-1420 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Leslie K Mosley Lnm | 9 Roberts St, Malden, MA 02148 | Controlled Substance Registration for Practitioner | 2004-02-29 ~ 2005-02-28 |
| Matthew B.w. Edwards | 55 Leslie Ln, Fairfield, CT 06824-1665 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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| 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).