MIREYA WESSOLOSSKY
Controlled Substance Registration for Practitioner


Address: 9 Old Farm Circle, Shrewsbury, MA 01545

MIREYA WESSOLOSSKY (Credential# 383136) 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 INACTIVE.

Business Overview

MIREYA WESSOLOSSKY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0036488. 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 9 Old Farm Circle, Shrewsbury, MA 01545. The current status is inactive.

Basic Information

Licensee Name MIREYA WESSOLOSSKY
Credential ID 383136
Credential Number CSP.0036488
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 9 Old Farm Circle
Shrewsbury
MA 01545
Business Type INDIVIDUAL
Status INACTIVE - LACK OF ACTIVE MEDICAL LICENSE
Issue Date 2004-09-21
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2020-04-24

Other licenses

ID Credential Code Credential Type Issue Term Status
554598 1.037008 Physician/Surgeon 1998-06-26 2018-12-01 - 2019-11-30 INACTIVE

Office Location

Street Address 9 OLD FARM CIRCLE
City SHREWSBURY
State MA
Zip Code 01545

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Pooja Laxminarayan Jangid 16 Thestland Dr., Shrewsbury, MA 01545 Physical Therapist ~
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Grisham M Bryan 30 Stonybrook Lane, Shrewsbury, MA 01545 Casino Class I Employee 2019-12-03 ~ 2020-10-31
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Competitor

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City SHREWSBURY
Zip Code 01545
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SHREWSBURY

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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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