ROBERT WILLSON (Credential# 1345256) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
ROBERT WILLSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0062430. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 1521 Monte Sano Ave, Augusta, GA 30904-5399. The current status is lapsed.
| Licensee Name | ROBERT WILLSON |
| Credential ID | 1345256 |
| Credential Number | CSP.0062430 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1521 Monte Sano Ave Augusta GA 30904-5399 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2016-04-26 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1344784 | 1.055724 | Physician/Surgeon | 2016-09-09 | 2016-09-09 - 2017-09-30 | INACTIVE |
| Street Address | 1521 MONTE SANO AVE |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-5399 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| David L Booker | 2321 Kings Way, Augusta, GA 30904 | Physician/surgeon | 2017-02-01 ~ 2018-01-31 |
| Change Gangs Virtural Giving Circles Inc · None | 1041 Via Real, Loveland, CO 30904 | Public Charity-exempt From Financial Requirements | 2015-11-20 ~ |
| Thomas J Kile Jr | 2220 Lee St, Augusta, GA 30904 | Pharmacist | 2011-02-01 ~ 2012-01-31 |
| Dominique C Harmon | 792 Eve Street, Augusta, GA 30904 | Licensed Clinical Social Worker | 2004-02-02 ~ 2005-02-28 |
| Buffye Warthaw | 10823 Cooney Circle, Agusta, GA 30904 | Registered Nurse | 2006-12-13 ~ 2007-02-28 |
| Robert W Kogel Md | 2301 Laurel Ln, Augusta, GA 30904-3137 | Controlled Substance Registration for Practitioner | 2019-11-13 ~ 2021-02-28 |
| Dwight Mirmow | 1435 Heard Ave, Augusta, GA 30904-4719 | Physician/surgeon | 2016-02-01 ~ 2017-01-31 |
| Sanjiv Prabhu | 2260 Wrightsboro Rd, Augusta, GA 30904-4764 | Physician/surgeon | 2018-08-01 ~ 2019-07-31 |
| Charles W Jones | 1910 Thomas Ln, Augusta, GA 30904-5114 | Architect | 2020-08-01 ~ 2021-07-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Family Planning Association of Maine Inc | 43 Gabriel Dr, Augusta, ME 04330-7852 | Public Charity | 2019-03-05 ~ 2020-05-31 |
| June Yowtak | 2095 Willhaven Dr, Augusta, GA 30909 | Resident Physician | 2017-07-07 ~ 2021-06-30 |
| Amd Medicom Inc | 4049 Allen Station Rd Ste A, Augusta, GA 30906-8734 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Augusta Medical Systems LLC | 1027 Broad St, Augusta, GA 30901-1142 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Kenny Susanto | 1120 15th St, Augusta, GA 30912 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Elizabeth B Eubanks | 2829 Lombardy Ct, Augusta, GA 30909-3901 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Yumeris De Jesus Baez | 2803 Ridgecrest Dr, Augusta, GA 30907-4821 | Registered Nurse | ~ |
| Carrie Lynn Wimer | 165 Queen Dr, Augusta, WV 26704-7643 | Registered Nurse - Temporary | 2020-04-30 ~ 2020-08-28 |
| Richard J Raskin | 15 Enterprise Dr, Augusta, ME 04330-7997 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Glenn A Calabrese | 2 Grant Ct, Augusta, NJ 07822-2158 | Asbestos Consultant-inspector | 2020-03-01 ~ 2021-02-28 |
| Find all Licenses in AUGUSTA | |||
| City | AUGUSTA |
| Zip Code | 30904 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + AUGUSTA |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robert F Maier | 9 Robert Street, Somers, CT 06071 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Robert C. Piela | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 | |
| Robert S Madenjian | P O Box 285, Brooklyn, CT 06234 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Robert J Conrad Md | Po Box 747, Koloa, HI 96756 | Controlled Substance Registration for Practitioner | 2001-03-01 ~ 2002-02-28 |
| Robert J Miller Dds | 133 Fifth St, Stamford, CT 06905 | Controlled Substance Registration for Practitioner | 1996-03-01 ~ 1997-02-28 |
| Robert D Lew | 101 Village Dr Apt 508, Wethersfield, CT 06109-4635 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Robert S Kelley | Bethel, CT 06810 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Robert Greenstein | 41 Fox Den Rd, Avon, CT 06001-2507 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Robert S Wetmore Md | P.o. Box 490, Plantsville, CT 06479 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Robert Strange Pa | P.o. Box 847, Wellfleet, MA 02667-0847 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
Please comment or provide details below to improve the information on ROBERT WILLSON.
| 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).