JACY A STAUFFER DMD
Controlled Substance Registration for Practitioner


Address: 6055 Gloucester Ct., Salisbury, MD 21801

JACY A STAUFFER DMD (Credential# 937176) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2015. The license expiration date date is January 15, 2017. The license status is INACTIVE.

Business Overview

JACY A STAUFFER DMD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0047836. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2015. The expiration date is January 15, 2017. The business address is 6055 Gloucester Ct., Salisbury, MD 21801. The current status is inactive.

Basic Information

Licensee Name JACY A STAUFFER DMD
Credential ID 937176
Credential Number CSP.0047836
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 6055 Gloucester Ct.
Salisbury
MD 21801
Business Type INDIVIDUAL
Status INACTIVE - DOES NOT WISH TO RENEW
Issue Date 2010-07-01
Effective Date 2015-03-01
Expiration Date 2017-01-15
Refresh Date 2017-01-15

Other licenses

ID Credential Code Credential Type Issue Term Status
923809 2.010250 Dentist 2010-04-28 2014-10-01 - 2015-09-30 INACTIVE

Office Location

Street Address 6055 Gloucester Ct.
City Salisbury
State MD
Zip Code 21801

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Competitor

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City Salisbury
Zip Code 21801
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Salisbury

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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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