CHAD LEWICK OD
Controlled Substance Registration for Practitioner


Address: 52 Victoria Dr, Poughquag, NY 12570

CHAD LEWICK OD (Credential# 143480) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2009. The license expiration date date is February 28, 2011. The license status is INACTIVE.

Business Overview

CHAD LEWICK OD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0027502. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2009. The expiration date is February 28, 2011. The business address is 52 Victoria Dr, Poughquag, NY 12570. The current status is inactive.

Basic Information

Licensee Name CHAD LEWICK OD
Credential ID 143480
Credential Number CSP.0027502
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 52 Victoria Dr
Poughquag
NY 12570
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2009-03-01
Expiration Date 2011-02-28
Refresh Date 2013-03-07

Other licenses

ID Credential Code Credential Type Issue Term Status
763073 3.002445 Optometrist 1997-05-09 2003-07-25 - 2004-09-30 INACTIVE

Office Location

Street Address 52 VICTORIA DR
City POUGHQUAG
State NY
Zip Code 12570

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Michael R Piela 437 Depot Hill Rd, Poughquag, NY 12570 Pharmacist 2020-02-01 ~ 2022-01-31
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Competitor

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City POUGHQUAG
Zip Code 12570
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + POUGHQUAG

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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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