MALCOLM S EDGAR JR
Physician/surgeon


Address: 410 Washington St, Norwich, CT 06360

MALCOLM S EDGAR JR (Credential# 540510) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 10, 2000. The license expiration date date is March 31, 2001. The license status is INACTIVE.

Business Overview

MALCOLM S EDGAR JR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.012859. The credential type is physician/surgeon. The effective date is January 10, 2000. The expiration date is March 31, 2001. The business address is 410 Washington St, Norwich, CT 06360. The current status is inactive.

Basic Information

Licensee Name MALCOLM S EDGAR JR
Credential ID 540510
Credential Number 1.012859
Credential Type Physician/Surgeon
Business Address 410 Washington St
Norwich
CT 06360
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1967-01-20
Effective Date 2000-01-10
Expiration Date 2001-03-31
Refresh Date 2009-07-08

Other licenses

ID Credential Code Credential Type Issue Term Status
149026 CSP.0004870 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 1998-03-01 - 1999-02-28 INACTIVE

Office Location

Street Address 410 WASHINGTON ST
City NORWICH
State CT
Zip Code 06360

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City NORWICH
Zip Code 06360
License Type Physician/Surgeon
License Type + County Physician/Surgeon + NORWICH

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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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