KATHERINE M WAGNER-REISS MD
Physician/surgeon


Address: 434 Frogtown Rd, New Canaan, CT 06840-4411

KATHERINE M WAGNER-REISS MD (Credential# 545527) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2015. The license expiration date date is November 30, 2016. The license status is INACTIVE.

Business Overview

KATHERINE M WAGNER-REISS MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.025577. The credential type is physician/surgeon. The effective date is December 1, 2015. The expiration date is November 30, 2016. The business address is 434 Frogtown Rd, New Canaan, CT 06840-4411. The current status is inactive.

Basic Information

Licensee Name KATHERINE M WAGNER-REISS MD
Credential ID 545527
Credential Number 1.025577
Credential Type Physician/Surgeon
Business Address 434 Frogtown Rd
New Canaan
CT 06840-4411
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL; PRIOR DISCIPLINE
Issue Date 1984-05-22
Effective Date 2015-12-01
Expiration Date 2016-11-30
Refresh Date 2017-09-23

Other licenses

ID Credential Code Credential Type Issue Term Status
492944 CSP.0043049 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2008-01-29 2013-03-01 - 2015-02-28 INACTIVE

Office Location

Street Address 434 FROGTOWN RD
City NEW CANAAN
State CT
Zip Code 06840-4411

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Lia Marie Ferro 432 Frogtown Rd, New Canaan, CT 06840-4411 Honey Bee Registration 2020-04-13 ~ 2020-09-30

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49 Midwood LLC 97 Dans Hwy, New Canaan, CT 06840 New Home Construction Contractor 2020-06-26 ~ 2021-09-30
Hyun Park 15 Locust Ave, New Canaan, CT 06840 Esthetician 2020-06-26 ~ 2022-04-30
Guy R Mazzola 1484 Oenoke Ridge, New Canaan, CT 06840 Public Weigher 2020-07-01 ~ 2021-06-30
Mairin E Mara 184 Lukes Wood Rd, New Canaan, CT 06840 Real Estate Salesperson 2020-06-01 ~ 2021-05-31
Hannah Simpson 33 Sleepy Hollow Road, New Canaan, CT 06840 Esthetician ~
Susan Mcclellan Valk 301 Oenoke Ridge Road, New Canaan, CT 06840 Real Estate Salesperson 2020-06-23 ~ 2021-05-31
New Canaan Gulf · Haviland Ent Ltd Dba 36 South Ave, New Canaan, CT 06840 Operator of Weighing & Measuring Devices 2020-08-01 ~ 2021-07-31
Claire Cheng 226 Buttery Road, New Canaan, CT 06840 Marital and Family Therapist Associate 2020-06-24 ~ 2022-06-24
Joes Pizza 23 Locust Avenue, New Canaan, CT 06840 Bakery 2020-07-01 ~ 2021-06-30
Kathleen Mary Berchelmann 711 Silvermine Rd, New Canaan, Ct, CT 06840 Physician/surgeon 2020-07-01 ~ 2021-06-30
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Competitor

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City NEW CANAAN
Zip Code 06840
License Type Physician/Surgeon
License Type + County Physician/Surgeon + NEW CANAAN

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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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