LORI L WILSON MD (Credential# 414319) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 17, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.
LORI L WILSON MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0038060. The credential type is controlled substance registration for practitioner. The effective date is March 17, 2011. The expiration date is February 28, 2013. The business address is 263 Farmington Avenue, Farmington, CT 06030-3955. The current status is inactive.
| Licensee Name | LORI L WILSON MD |
| Credential ID | 414319 |
| Credential Number | CSP.0038060 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
263 Farmington Avenue Farmington CT 06030-3955 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2005-09-19 |
| Effective Date | 2011-03-17 |
| Expiration Date | 2013-02-28 |
| Refresh Date | 2014-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 561381 | 1.043799 | Physician/Surgeon | 2005-09-09 | 2010-07-01 - 2011-06-30 | INACTIVE |
| Street Address | 263 FARMINGTON AVENUE |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-3955 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Davis Aasen | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Christopher D Lemoine | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Dylan Buller | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Jennifer Lindelof | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Colin J Pavano | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Barrett B Torre | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Samantha Slattery | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Ethan A Miller | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-06-28 ~ 2024-06-30 |
| Patrick Bergamo | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-06-28 ~ 2024-06-30 |
| Shriya Gupta | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-06-28 ~ 2024-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Adam T. Tyson | 263 Farmington Ave Mc-3955, Farmington, CT 06030-3955 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Xuan M Luu Md | 263 Farmington Avenue Mc-3955, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2013-06-07 ~ 2015-02-28 |
| Andrew S Nisbet | 262 Farmington Avenue Mc-3955, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Alisa M.d. Berger | 263 Farmington Ave Mc 3955, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2007-03-28 ~ 2008-02-29 |
| Carl K Gjertson | Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Peter C Albertsen | Uconn Health Center, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Bruce M Brenner | 263 Farmington Ave, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Michael S Dahn Md | Uconn Health Ctr, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Kiranmayi Muddasani | 263 Farmington Ave Mc-3955, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2013-04-26 ~ 2015-02-28 |
| Jeffrey Wu | 263 Farmington Ave Mc-3955, Farmington, CT 06030-3955 | Physician/surgeon | 2012-10-25 ~ 2013-07-31 |
| Find all Licenses in zip 06030-3955 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | FARMINGTON |
| Zip Code | 06030 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lori Pelosi | 619 Guernseytown Rd, Watertown, CT 06795-1820 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lori D Lerner | 5 Cranbrook, Avon, CT 06001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lori A. Weir Md | 521 Oakhurst Rd, Mamaroneck, NY 10543-4004 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Lori J Ellis | 129 York St Apt 8a, New Haven, CT 06511-5606 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Lori A Wilfling Dvm | 6 Caldwell Ter, Danbury, CT 06810-5193 | Controlled Substance Registration for Practitioner | 2019-07-22 ~ 2021-02-28 |
| Lori Mcinns Dvm | 330 Main St, Norwalk, CT 06851 | Controlled Substance Registration for Practitioner | 1995-12-19 ~ 1997-02-28 |
| Lori Hvozdovic Pa | 31 Lynn Rd, Bristol, CT 06010-4464 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Lori A. Gauthier | 64 Robbins St, Waterbury, CT 06708-2613 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lori H Pai Md | 145 East 48th St. Apt 11h, New York, NY 10017 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Lori E Dennis | 125 W Main St, Clinton, CT 06413 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
Please comment or provide details below to improve the information on LORI L WILSON 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).