BRIAN W FULLEM
Podiatrist


Address: 54 South Main St., Newtown, CT 06470

BRIAN W FULLEM (Credential# 698995) is licensed (Podiatrist) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2010. The license expiration date date is November 30, 2011. The license status is INACTIVE.

Business Overview

BRIAN W FULLEM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #19.000556. The credential type is podiatrist. The effective date is December 1, 2010. The expiration date is November 30, 2011. The business address is 54 South Main St., Newtown, CT 06470. The current status is inactive.

Basic Information

Licensee Name BRIAN W FULLEM
Credential ID 698995
Credential Number 19.000556
Credential Type Podiatrist
Business Address 54 South Main St.
Newtown
CT 06470
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1991-08-07
Effective Date 2010-12-01
Expiration Date 2011-11-30
Refresh Date 2012-03-02

Other licenses

ID Credential Code Credential Type Issue Term Status
160378 CSP.0019455 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2009-03-01 - 2011-02-28 INACTIVE

Office Location

Street Address 54 SOUTH MAIN ST.
City NEWTOWN
State CT
Zip Code 06470

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Competitor

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City NEWTOWN
Zip Code 06470
License Type Podiatrist
License Type + County Podiatrist + NEWTOWN

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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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