KARLA L WAGNER
Physician/surgeon


Address: 19 Wright St #2, Stamford, CT 06902

KARLA L WAGNER (Credential# 551017) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 1, 1993. The license expiration date date is October 31, 1994. The license status is INACTIVE.

Business Overview

KARLA L WAGNER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.033418. The credential type is physician/surgeon. The effective date is December 1, 1993. The expiration date is October 31, 1994. The business address is 19 Wright St #2, Stamford, CT 06902. The current status is inactive.

Basic Information

Licensee Name KARLA L WAGNER
Credential ID 551017
Credential Number 1.033418
Credential Type Physician/Surgeon
Business Address 19 Wright St #2
Stamford
CT 06902
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1993-11-12
Effective Date 1993-12-01
Expiration Date 1994-10-31
Refresh Date 2009-07-08

Office Location

Street Address 19 WRIGHT ST #2
City STAMFORD
State CT
Zip Code 06902

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Andrea Bynoe 34 Melrose Pl, Stamford, CT 06902 Notary Public Appointment 1994-04-06 ~ 1999-04-30
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Competitor

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City STAMFORD
Zip Code 06902
License Type Physician/Surgeon
License Type + County Physician/Surgeon + STAMFORD

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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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