BRIAN K WAGNER (Credential# 380823) 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.
BRIAN K WAGNER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0036162. 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 11 South Rd, Farmington, CT 06032-2483. The current status is active.
| Licensee Name | BRIAN K WAGNER |
| Credential ID | 380823 |
| Credential Number | CSP.0036162 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
11 South Rd Farmington CT 06032-2483 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2004-10-15 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1400800 | CSP.0064698 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-02-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 699230 | 19.000793 | Podiatrist | 2004-06-30 | 2019-11-01 - 2020-10-31 | ACTIVE |
| 916006 | 19.000862-STND | Standard Ankle Surgery Permit | 2010-02-19 | 2010-02-19 - | ACTIVE |
| Street Address | 11 SOUTH RD |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06032-2483 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ruey-jane Jane Wu | 11 South Rd, Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Po-cheng Tsai Dmd | 11 South Rd, Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Farmington Dialysis | 11 South Rd Ste 110, Farmington, CT 06032-2483 | Hemodialysis | 2018-10-01 ~ 2020-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kyeongsuk Lee Lee | 11- A1 Lakeshore Dr, Farmington, CT 06032 | Nail Technician | ~ |
| Lynne M Ramer · Sobowicz | 13 Wentworth Park, Farmington, CT 06032 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Scott's Townline Mobil LLC | 435 Main St, Farmington, CT 06032 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Glenna E Voytovich · Mietz | 47 Carriage Dr, Farmington, CT 06032 | Marital and Family Therapist | 2020-09-01 ~ 2021-08-31 |
| Munsons Chocolates | 463 Westfarms Mall, Farmington, CT 06032 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Kimberly A. Caprio | Hartford Healthcare Medical Group, Farmington, CT 06032 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Stephanie A. Fink | 22 Kent Lane, Farmington, CT 06032 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Farmington Donuts LLC · Dunkins Donuts | 348 Colt Hwy, Farmington, CT 06032 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Angham Zakko | 2 Stratford Rd., Farmington, CT 06032 | Architect | 2020-08-01 ~ 2021-07-31 |
| Thomas N Taylor | 222 Main St # 264, Farmington, CT 06032 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06032 | |||
| City | FARMINGTON |
| Zip Code | 06032 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Thomas J Wagner | 540 Route 148, Killingworth, CT 06419 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Krystn R Wagner | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jessica L Wagner | 227 Church St Apt 7c, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Brian R Pulford | 21 Brian Road, West Hartford, CT 06110 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Joseph R Wagner Md | 85 Seymour St Suite 416, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Todd L Wagner Do | 40 Middlefield St, Groton Long Pt, CT 06340 | Controlled Substance Registration for Practitioner | ~ 2001-02-28 |
| Matthew P Wagner | 1450 Chapel St, New Haven, CT 06511-4405 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Annette V Wagner Md | 7 Niagara Pier, Erie, PA 16507 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Peter John Wagner | 162 Dawley Dr., Stonington, CT 06378 | Controlled Substance Registration for Practitioner | 2019-04-02 ~ 2021-02-28 |
| James L. Wagner | 1608 Riverview Rd, Chattanooga, TN 37405-3131 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
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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).