TRACY L MACINTOSH
Controlled Substance Registration for Practitioner


Address: 23 Oxbow Dr, Meriden, CT 06450-6938

TRACY L MACINTOSH (Credential# 952120) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.

Business Overview

TRACY L MACINTOSH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0048828. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2013. The expiration date is February 28, 2015. The business address is 23 Oxbow Dr, Meriden, CT 06450-6938. The current status is inactive.

Basic Information

Licensee Name TRACY L MACINTOSH
Credential ID 952120
Credential Number CSP.0048828
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 23 Oxbow Dr
Meriden
CT 06450-6938
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2010-11-12
Effective Date 2013-03-01
Expiration Date 2015-02-28
Refresh Date 2016-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
1149590 1.051790 Physician/Surgeon 2013-04-15 2013-09-01 - 2014-08-31 INACTIVE

Office Location

Street Address 23 OXBOW DR
City MERIDEN
State CT
Zip Code 06450-6938

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Henry Zhang · Orifood 39 Oxbow Dr, Meriden, CT 06450-6938 Cottage Food Operation 2020-05-26 ~ 2021-02-28
Siobhon K Andrews 39 Oxbow Dr, Meriden, CT 06450-6938 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28

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Competitor

Search similar business entities

City MERIDEN
Zip Code 06450
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MERIDEN

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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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