FREDERIC T MAUCK
Physician/surgeon


Address: 12 Porter Rd, Farmington, CT 06032

FREDERIC T MAUCK (Credential# 539898) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2017. The license expiration date date is May 31, 2018. The license status is INACTIVE.

Business Overview

FREDERIC T MAUCK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.011113. The credential type is physician/surgeon. The effective date is June 1, 2017. The expiration date is May 31, 2018. The business address is 12 Porter Rd, Farmington, CT 06032. The current status is inactive.

Basic Information

Licensee Name FREDERIC T MAUCK
Credential ID 539898
Credential Number 1.011113
Credential Type Physician/Surgeon
Business Address 12 Porter Rd
Farmington
CT 06032
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1962-10-02
Effective Date 2017-06-01
Expiration Date 2018-05-31
Refresh Date 2018-09-03

Other licenses

ID Credential Code Credential Type Issue Term Status
148919 CSP.0000325 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2007-03-01 - 2008-02-29 INACTIVE

Office Location

Street Address 12 PORTER RD
City FARMINGTON
State CT
Zip Code 06032

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Competitor

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City FARMINGTON
Zip Code 06032
License Type Physician/Surgeon
License Type + County Physician/Surgeon + FARMINGTON

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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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