MARK CONWAY MD
Controlled Substance Registration for Practitioner


Address: 28 Juniper Lane, West Hartford, CT 06117

MARK CONWAY MD (Credential# 147629) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2007. The license expiration date date is February 29, 2008. The license status is INACTIVE.

Business Overview

MARK CONWAY MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0004619. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2007. The expiration date is February 29, 2008. The business address is 28 Juniper Lane, West Hartford, CT 06117. The current status is inactive.

Basic Information

Licensee Name MARK CONWAY MD
Credential ID 147629
Credential Number CSP.0004619
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 28 Juniper Lane
West Hartford
CT 06117
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2007-03-01
Expiration Date 2008-02-29
Refresh Date 2009-02-05

Other licenses

ID Credential Code Credential Type Issue Term Status
538774 1.006962 Physician/Surgeon 1952-06-12 2006-10-23 - 2007-12-31 INACTIVE

Office Location

Street Address 28 JUNIPER LANE
City WEST HARTFORD
State CT
Zip Code 06117

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Competitor

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City WEST HARTFORD
Zip Code 06117
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WEST HARTFORD

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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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