PAUL L FORTGANG (Credential# 157084) 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.
PAUL L FORTGANG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0015732. 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 1 Long Wharf Dr Ste 302, New Haven, CT 06511-5593. The current status is active.
| Licensee Name | PAUL L FORTGANG |
| Credential ID | 157084 |
| Credential Number | CSP.0015732 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1 Long Wharf Dr Ste 302 New Haven CT 06511-5593 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 547280 | 1.028622 | Physician/Surgeon | 1987-10-26 | 2019-11-01 - 2020-10-31 | ACTIVE |
| Street Address | 1 LONG WHARF DR Ste 302 |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511-5593 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John M Willett | 1 Long Wharf Dr Ste 302, New Haven, CT 06511-5593 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Howard Boey | 1 Long Wharf Dr Ste 302, New Haven, CT 06511-5593 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Maria Byrne | 1 Long Wharf Dr Ste 302, New Haven, CT 06511-5593 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Tiffany Tsie-yiu Chen | 1 Long Wharf Dr Ste 302, New Haven, CT 06511-5593 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Ken Yanagisawa | 1 Long Wharf Dr Ste 302, New Haven, CT 06511-5593 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Jeffrey Paul Cranford | 1 Long Wharf Dr Ste 302, New Haven, CT 06511-5593 | Controlled Substance Registration for Practitioner | 2019-03-12 ~ 2021-02-28 |
| Samantha Almeida | 1 Long Wharf Dr Ste 302, New Haven, CT 06511-5593 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Ronald H Hirokawa | 1 Long Wharf Dr Ste 302, New Haven, CT 06511-5593 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| M B Shimelman Md | 1 Long Wharf Dr Ste 302, New Haven, CT 06511-5593 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark A D'agostino | 1 Long Wharf Dr Ste 302, New Haven, CT 06511-5593 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael J Robbins Do | 1 Long Wharf Dr Ste 212, New Haven, CT 06511-5593 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Dwight Ligham Md | 1 Long Wharf Dr Ste 212, New Haven, CT 06511-5593 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Marilou Oh | 1 Long Wharf Dr, New Haven, CT 06511-5593 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Montessori School On Edgewood Inc. | 230 Edgewood Avenue, New Haven, CT 06511 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Therese Parks · Visel Drug Store | 264 Munson St, New Haven, CT 06511 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dazjia Monet Green | 115 Edgewood Ave Apt 64, New Haven, CT 06511 | Registered Nurse | 2020-06-27 ~ 2021-05-31 |
| Carol Yam | 343 Humphrey St, New Haven, CT 06511 | Registered Nurse | ~ |
| Marwan S Haddad | 38 Lincoln Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mary Lou Gaeta Md | 558 Chapel Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Cary M Tucker | 64 Bishop St, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Frank J Pannenborg | 505 Ellsworth Ave, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Crystal E Gooding | 26 Woodland Street, New Haven, CT 06511 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Kieran Jones | 260 Crown St Unit 1f, New Haven, CT 06511 | Registered Nurse | ~ |
| Find all Licenses in zip 06511 | |||
| City | NEW HAVEN |
| Zip Code | 06511 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael Fortgang Md | 230 Saugatuck Ave, Westport, CT 06880 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Paul H Zimmering Md | Po Box 580, Wallingford, CT 06492-0580 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Paul Fox Md | 2 Old New Milford Rd Ste 1e, Brookfield, CT 06804-2426 | Controlled Substance Registration for Practitioner | 2011-03-23 ~ 2013-02-28 |
| Paul D Kang | 217 Se 8th St, Ankeny, IA 50021-3538 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Paul Himelfarb | 13 Top of The Rdg, Mamaroneck, NY 10543-1734 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Paul Pyo | 893 Cahill Ct, Cheshire, CT 06410-3302 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Joan Paul | 680 Mix Ave Apt 3p, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2009-10-19 ~ 2011-02-28 |
| Paul G Harvill Md | 41 Brewster Rd, Bristol, CT 06010-5161 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Paul A Kraus | 160 Robbins St, Waterbury, CT 06708 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Paul R Kelly D.o. | 761 Main Ave Ste 201, Norwalk, CT 06851-1005 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on PAUL L FORTGANG.
| 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).