TRACY S WANG MD
Controlled Substance Registration for Practitioner


Address: 109 Church St Apt 401, New Haven, CT 06510

TRACY S WANG MD (Credential# 446093) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2007. The license expiration date date is February 29, 2008. The license status is INACTIVE.

Business Overview

TRACY S WANG MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0039772. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2007. The expiration date is February 29, 2008. The business address is 109 Church St Apt 401, New Haven, CT 06510. The current status is inactive.

Basic Information

Licensee Name TRACY S WANG MD
Credential ID 446093
Credential Number CSP.0039772
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 109 Church St Apt 401
New Haven
CT 06510
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2006-10-12
Effective Date 2007-03-01
Expiration Date 2008-02-29
Refresh Date 2009-02-05

Other licenses

ID Credential Code Credential Type Issue Term Status
562038 1.044456 Physician/Surgeon 2006-06-06 2006-11-29 - 2008-01-31 INACTIVE

Office Location

Street Address 109 CHURCH ST APT 401
City NEW HAVEN
State CT
Zip Code 06510

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Competitor

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City NEW HAVEN
Zip Code 06510
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW HAVEN

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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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