ANDREW C FOSSUM (Credential# 1348024) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is INACTIVE.
ANDREW C FOSSUM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0062481. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 3629 Bahnman Dr, Mckinney, TX 75070-4802. The current status is inactive.
| Licensee Name | ANDREW C FOSSUM |
| Credential ID | 1348024 |
| Credential Number | CSP.0062481 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
3629 Bahnman Dr Mckinney TX 75070-4802 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LACK OF ACTIVE MEDICAL LICENSE |
| Issue Date | 2016-04-19 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-04-21 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1330238 | 2.011588 | Dentist | 2016-04-14 | 2018-07-01 - 2019-06-30 | INACTIVE |
| 1488137 | 2.012014-RES | Resident Dentist | 2016-07-01 | 2016-07-01 - 2019-06-30 | INACTIVE |
| Street Address | 3629 BAHNMAN DR |
| City | MCKINNEY |
| State | TX |
| Zip Code | 75070-4802 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lisa Simone Bell | 4112 Temecula Creek Trail, Mckinney, TX 75070 | Registered Nurse | 2020-05-22 ~ 2021-03-31 |
| Bonny Carole Glenn | 3437 Beaver Creek Lane, Mckinney, TX 75070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Alliance Sales | 2240 Bush Drive, Mckinney, TX 75070 | Importer of Bedding & Upholstered Furniture | 2020-05-01 ~ 2021-04-30 |
| Stephani Kristin Cramer | 4905 Clove Ct, Mckinney, TX 75070 | Registered Nurse | 2020-02-03 ~ 2020-11-30 |
| Lauren Ashlee Stevens | 3415 Ruidoso Lane, Mckinney, TX 75070 | Registered Nurse | 2019-10-01 ~ 2020-09-30 |
| Cynthia Laforge | 4507 Bellcrest Dr, Mckinney, TX 75070 | Registered Nurse | 2018-10-23 ~ 2019-08-31 |
| Jessica Marie Harrison | 5924 Pine Meadow Ln, Mckinney, TX 75070 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Susan Mccrimmon Stell | 5904 Quail Creek Drive, Mckinney, TX 75070 | Registered Nurse | 2017-10-01 ~ 2018-09-30 |
| Blockbuster Video | Po Box 8009, Mckinney, TX 75070 | Vending Machine Operator | 2004-07-01 ~ 2005-06-30 |
| Mary C Hilleary | 508 Mozart Way, Mckinney, TX 75070 | Registered Nurse | 2015-12-01 ~ 2016-11-30 |
| Find all Licenses in zip 75070 | |||
| City | MCKINNEY |
| Zip Code | 75070 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MCKINNEY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrew Kornstein Md PC | 539 Danbury Rd, Wilton, CT 06897-2216 | Controlled Substance Registration for Practitioner | 2015-11-12 ~ 2017-02-28 |
| Andrew Cha | 24 Hospital Ave, Danbury, CT 06810-6077 | Controlled Substance Registration for Practitioner | 2013-03-07 ~ 2015-02-28 |
| Andrew Lim | 81 Fieldstone Run, Farmington, CT 06032-2741 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Andrew E Kim Md | 2 Foxhall Rd, Newtown, PA 18940-2930 | Controlled Substance Registration for Practitioner | 2015-06-15 ~ 2017-02-28 |
| Andrew B Kirk Pa | 31 River Rd, Cos Cob, CT 06807-2152 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Richard L Yap Md | 151 Andrew Ave Apt 85, Naugatuck, CT 06770 | Controlled Substance Registration for Practitioner | 2003-03-01 ~ 2004-02-28 |
| Andrew D Stiles | 201 Ann St Apt 305, Hartford, CT 06103-2000 | Controlled Substance Registration for Practitioner | 2015-07-27 ~ 2017-02-28 |
| Andrew Oh | 205 Church St Apt 2j, New Haven, CT 06510-1895 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Andrew J Yoon | 318 Elm St Apt A4, New Haven, CT 06511-4772 | Controlled Substance Registration for Practitioner | 2008-09-30 ~ 2009-02-28 |
| Andrew D Pearle | 390 Forest Ave, Rye, NY 10580-3613 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on ANDREW C FOSSUM.
| 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).