MARK C NITZBERG
Controlled Substance Registration for Practitioner


Address: 164 Hunter's Lane, Newington, CT 06111

MARK C NITZBERG (Credential# 160199) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is September 9, 1993. The license expiration date date is October 1, 1995. The license status is INACTIVE.

Business Overview

MARK C NITZBERG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0020340. The credential type is controlled substance registration for practitioner. The effective date is September 9, 1993. The expiration date is October 1, 1995. The business address is 164 Hunter's Lane, Newington, CT 06111. The current status is inactive.

Basic Information

Licensee Name MARK C NITZBERG
Credential ID 160199
Credential Number CSP.0020340
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 164 Hunter's Lane
Newington
CT 06111
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 1993-09-09
Expiration Date 1995-10-01
Refresh Date 2004-04-23

Other licenses

ID Credential Code Credential Type Issue Term Status
550097 1.032490 Physician/Surgeon 1992-07-31 1993-06-24 - 1994-06-30 INACTIVE

Office Location

Street Address 164 HUNTER'S LANE
City NEWINGTON
State CT
Zip Code 06111

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City NEWINGTON
Zip Code 06111
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEWINGTON

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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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