WAYNE A FREDERICK MD (Credential# 333513) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 24, 2006. The license expiration date date is February 28, 2007. The license status is INACTIVE.
WAYNE A FREDERICK MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0033288. The credential type is controlled substance registration for practitioner. The effective date is March 24, 2006. The expiration date is February 28, 2007. The business address is 103 Mallard Dr, Avon, CT 06001. The current status is inactive.
| Licensee Name | WAYNE A FREDERICK MD |
| Credential ID | 333513 |
| Credential Number | CSP.0033288 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
103 Mallard Dr Avon CT 06001 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2005-03-01 |
| Effective Date | 2006-03-24 |
| Expiration Date | 2007-02-28 |
| Refresh Date | 2009-01-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 558917 | 1.041334 | Physician/Surgeon | 2003-04-09 | 2005-06-16 - 2006-06-30 | INACTIVE |
| Street Address | 103 MALLARD DR |
| City | AVON |
| State | CT |
| Zip Code | 06001 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Julie R Deitch | 5 Bridle Path, Avon, CT 06001 | Dental Hygienist | 2020-07-01 ~ 2021-06-30 |
| Brigitte Nicole Heleniak | 16 Sunset Trail, Avon, CT 06001 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Coffee Trade Inc (the) | 21 West Main St, Avon, CT 06001 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Elizabeth Stockwell | 44 Applewood Lane, Avon, CT 06001 | Real Estate Salesperson | ~ |
| Mollie Velma Lahaie | 14 Red Mountain Lane, Avon, CT 06001 | Registered Nurse | 2020-06-26 ~ 2020-08-31 |
| Meiling Chen | Avon Nail 315 W Main Street, Avon, CT 06001 | Nail Technician | ~ |
| Richard J Kaiser | 72 Westland Road, Avon, CT 06001 | Architect | 2020-08-01 ~ 2021-07-31 |
| Michele L Sweitzer | 12 Bluestone Lane, Avon, CT 06001 | Real Estate Salesperson | 2020-06-25 ~ 2021-05-31 |
| Caroline O Amin | 5 Colby Way, Avon, CT 06001 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Christine Burns | 102 New Road, Avon, CT 06001 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06001 | |||
| City | AVON |
| Zip Code | 06001 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + AVON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Frederick R Amore | Po Box 993, Branford, CT 06405 | Controlled Substance Registration for Practitioner | 1993-05-19 ~ 1995-06-01 |
| Frederick E Yeo | 86 School St., Groton, CT 06340 | Controlled Substance Registration for Practitioner | 2019-05-21 ~ 2021-02-28 |
| Frederick A Gluszek II | 35 New Rd, Tolland, CT 06084-3731 | Controlled Substance Registration for Practitioner | 2018-12-21 ~ 2021-02-28 |
| Wayne Yan | 129 York St Apt 6a, New Haven, CT 06511-5656 | Controlled Substance Registration for Practitioner | 2009-10-08 ~ 2011-02-28 |
| Roy H Kim | 3450 Wayne Ave Apt 21a, Bronx, NY 10467-2513 | Controlled Substance Registration for Practitioner | 2015-01-09 ~ 2017-02-28 |
| Frederick E Mott Md | 75 Westwood Rd, New Haven, CT 06515 | Controlled Substance Registration for Practitioner | 1995-12-19 ~ 1997-02-28 |
| Frederick L Ramos | 267 Grant St, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Jaya Singh | 20 Frederick St Apt 304, Hartford, CT 06105-4521 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Frederick Flatow | 138 State St, Guilford, CT 06437 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Denise Pumphrey | 7 1/2 Frederick St, Westfield, MA 01085-3105 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
Please comment or provide details below to improve the information on WAYNE A FREDERICK 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).