LOIS M BRENNER PA-C
Controlled Substance Registration for Practitioner


Address: 12 East 86 St Apt 1230, New York, NY 10028

LOIS M BRENNER PA-C (Credential# 458251) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.

Business Overview

LOIS M BRENNER PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0040961. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2013. The expiration date is February 28, 2015. The business address is 12 East 86 St Apt 1230, New York, NY 10028. The current status is inactive.

Basic Information

Licensee Name LOIS M BRENNER PA-C
Credential ID 458251
Credential Number CSP.0040961
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 12 East 86 St Apt 1230
New York
NY 10028
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2006-12-14
Effective Date 2013-03-01
Expiration Date 2015-02-28
Refresh Date 2016-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
743603 23.001854 Physician Assistant 2006-11-08 2011-09-01 - 2012-08-31 INACTIVE

Office Location

Street Address 12 EAST 86 ST APT 1230
City NEW YORK
State NY
Zip Code 10028

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Competitor

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City NEW YORK
Zip Code 10028
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW YORK

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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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