THOMAS JOSEPH DOMINGUEZ
Controlled Substance Registration for Practitioner


Address: 749 Farmington Ave Apt 3w, West Hartford, CT 06119

THOMAS JOSEPH DOMINGUEZ (Credential# 1604584) 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

THOMAS JOSEPH DOMINGUEZ is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0069637. 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 749 Farmington Ave Apt 3w, West Hartford, CT 06119. The current status is active.

Basic Information

Licensee Name THOMAS JOSEPH DOMINGUEZ
Credential ID 1604584
Credential Number CSP.0069637
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 749 Farmington Ave Apt 3w
West Hartford
CT 06119
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2018-09-28
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2019-01-28

Other licenses

ID Credential Code Credential Type Issue Term Status
1597068 23.004269 Physician Assistant 2018-09-28 2019-07-01 - 2020-06-30 ACTIVE

Office Location

Street Address 749 FARMINGTON AVE APT 3W
City WEST HARTFORD
State CT
Zip Code 06119

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Competitor

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City WEST HARTFORD
Zip Code 06119
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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