LINDA N FAGAN MD (Credential# 163232) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
LINDA N FAGAN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0023857. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 24 Independence Dr, Basking Ridge, NJ 07920. The current status is active.
| Licensee Name | LINDA N FAGAN MD |
| Credential ID | 163232 |
| Credential Number | CSP.0023857 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
24 Independence Dr Basking Ridge NJ 07920 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 552532 | 1.034937 | Physician/Surgeon | 1995-11-03 | 2019-07-01 - 2020-06-30 | ACTIVE |
| Street Address | 24 INDEPENDENCE DR |
| City | BASKING RIDGE |
| State | NJ |
| Zip Code | 07920 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cheryl B Stewart · Herman | 25 Kings Ridge Road, Basking Rigdge, NJ 07920 | Physical Therapist | 2020-06-01 ~ 2021-05-31 |
| Becht Engineering Bt Inc | 150 Allen Road, Basking Ridge, NJ 07920 | Professional Engineering Corporation | 2020-06-17 ~ 2021-06-16 |
| Lama El Zein | 131 Morristown Road, Basking Ridge, NJ 07920 | Physician/surgeon | 2020-03-03 ~ 2021-03-31 |
| Peter B Blank Do | 150 N Finley Ave, Basking Ridge, NJ 07920 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Laurie E Becht | 150 Allen Road #301, Basking Ridge, NJ 07920 | Professional Engineer | 2019-02-01 ~ 2020-01-31 |
| Nick Ivanoff | 3 Dexter Drive North, Basking Ridge, NJ 07920 | Professional Engineer | 2019-02-01 ~ 2020-01-31 |
| Philip M Grenci | 17 Compton Ct, Basking Ridge, NJ 07920 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Brian J Kirkpatrick | 71 Highland Ave, Basking Ridge, NJ 07920 | Certified Public Accountant License | 2020-01-01 ~ 2020-12-31 |
| Charles Becht V | 84 Blackburn Rd, Basking Ridge, NJ 07920 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Donna L Collura | 115 Riverside Drive, Basking Ridge, NJ 07920 | Notary Public Appointment | 2012-05-01 ~ 2017-04-30 |
| Find all Licenses in zip 07920 | |||
| City | BASKING RIDGE |
| Zip Code | 07920 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BASKING RIDGE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Claire G Fagan | 7 Cardinal Rd., Simsbury, CT 06070 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tara T S Fagan | 7 Partridge Hollow Rd, Killingworth, CT 06419-1025 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Linda L Fan | 14 Horseshoe Rd, Guilford, CT 06437-2918 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Linda C La | 157 Church St., New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Linda D Gillam Md | 55 Old Farm Rd, Hamden, CT 06517 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Linda L Meyer | 320 Lakeview Ave, Waterbury, CT 06705-2145 | Controlled Substance Registration for Practitioner | 2019-03-18 ~ 2021-02-28 |
| Linda J Oeser | 150 Kent Ave, Suffield, CT 06078 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Linda E Magee | 119 Rivercliff Dr, Milford, CT 06460 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Linda Thomson Aprn | 115 Elm St, Enfield, CT 06082 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Linda J Robson Dds | 64 Washington St, Mystic, CT 06355 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on LINDA N FAGAN MD.
| 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).