IRWIN AUGUST
Controlled Substance Registration for Practitioner


Address: 128 Five Fields Rd, Madison, CT 06443-2558

IRWIN AUGUST (Credential# 164275) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.

Business Overview

IRWIN AUGUST is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0022241. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2015. The expiration date is February 28, 2017. The business address is 128 Five Fields Rd, Madison, CT 06443-2558. The current status is inactive.

Basic Information

Licensee Name IRWIN AUGUST
Credential ID 164275
Credential Number CSP.0022241
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 128 Five Fields Rd
Madison
CT 06443-2558
Business Type INDIVIDUAL
Status INACTIVE - REVOKED
Issue Date 2006-03-01
Effective Date 2015-03-01
Expiration Date 2017-02-28
Refresh Date 2016-02-09

Other licenses

ID Credential Code Credential Type Issue Term Status
538124 1.000389-DO Physician/Surgeon 1994-05-27 2016-01-01 - 2016-12-31 INACTIVE

Office Location

Street Address 128 FIVE FIELDS RD
City MADISON
State CT
Zip Code 06443-2558

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Competitor

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City MADISON
Zip Code 06443
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MADISON

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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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