MEREDITH ANNE NIESS
Controlled Substance Registration for Practitioner


Address: 2416 Se 34th Ave Unit A, Portland, OR 97214-5760

MEREDITH ANNE NIESS (Credential# 1426220) 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 ACTIVE.

Business Overview

MEREDITH ANNE NIESS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0065571. 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 2416 Se 34th Ave Unit A, Portland, OR 97214-5760. The current status is active.

Basic Information

Licensee Name MEREDITH ANNE NIESS
Credential ID 1426220
Credential Number CSP.0065571
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 2416 Se 34th Ave Unit A
Portland
OR 97214-5760
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2017-05-24
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2019-02-11

Other licenses

ID Credential Code Credential Type Issue Term Status
1410134 1.056376 Physician/Surgeon 2017-04-24 2019-01-01 - 2019-12-31 INACTIVE

Office Location

Street Address 2416 SE 34TH AVE UNIT A
City PORTLAND
State OR
Zip Code 97214-5760

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Scott J Kane 3021 Se Stark, Portland, OR 97214 Hairdresser/cosmetician 1992-01-23 ~ 1992-12-31
Dana W Mozer 948 S E 14th Ave, Portland, OR 97214 Registered Nurse 1996-08-20 ~ 1997-10-31
Christie Sims 2924 Se Taylor St, Portland, OR 97214 Speech and Language Pathologist ~ 1999-05-31
Cynthia H Flagg 2219 Se 34th Avenue, Portland, OR 97214 Licensed Clinical Social Worker 2005-09-22 ~ 2006-09-30
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Competitor

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City PORTLAND
Zip Code 97214
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PORTLAND

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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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