BRENT MARTIN DDS (Credential# 167962) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is October 25, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.
BRENT MARTIN DDS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0024051. The credential type is controlled substance registration for practitioner. The effective date is October 25, 2013. The expiration date is February 28, 2015. The business address is 3461 Chandler Cove Way, Antioch, TN 37013. The current status is inactive.
| Licensee Name | BRENT MARTIN DDS |
| Credential ID | 167962 |
| Credential Number | CSP.0024051 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
3461 Chandler Cove Way Antioch TN 37013 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2005-03-01 |
| Effective Date | 2013-10-25 |
| Expiration Date | 2015-02-28 |
| Refresh Date | 2016-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 702679 | 2.008217 | Dentist | 1996-02-16 | 2013-10-01 - 2014-09-30 | INACTIVE |
| Street Address | 3461 Chandler Cove Way |
| City | Antioch |
| State | TN |
| Zip Code | 37013 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jerry I Onwu | 5249 Ridgefalls Way, Antioch, TN 37013 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Symmetry Surgical Inc | 3034 Owen Drive, Antioch, TN 37013 | Out of State Manufacturer of Drugs, Cosmetics & Medical Devices | 2018-04-25 ~ |
| Marion R Bowman · Joseph Fail Engr Co | 5645 Cane Ridge Rd, Antioch, TN 37013 | Professional Engineer | 1991-01-28 ~ 1992-01-31 |
| Bryan T. Meurer | 1759 Red Jacket Drive, Antioch, TN 37013 | Certified Public Accountant License | 2007-01-01 ~ 2007-12-31 |
| Raquel M Chaney | 4081 Barnes Cove Dr, Antioch, TN 37013 | Registered Nurse | 2010-01-12 ~ 2011-01-31 |
| Clara D Mathis | 623 Hickory Glade Court, Antioch, TN 37013 | Registered Nurse | 2009-11-01 ~ 2010-10-31 |
| Janice D Lewis | 6020 Monroe Crossing, Antioch, TN 37013 | Registered Nurse | 2009-07-13 ~ 2010-08-31 |
| Pamela J Dahlstrom | 1337 Paulson Way, Antioch, TN 37013 | Registered Nurse | 1992-01-23 ~ 2008-01-31 |
| Holly L Smith | 109 Cimarron Court, Antioch, TN 37013 | Registered Nurse | 2009-04-29 ~ 2010-04-30 |
| Adejoke Aina-babalola | 2031 Antioch Pike, Antioch, TN 37013 | Physician/surgeon | 2008-08-11 ~ 2009-09-30 |
| Find all Licenses in zip 37013 | |||
| City | Antioch |
| Zip Code | 37013 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Antioch |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brent J Nielsen | 227 Church St Apt 6h, New Haven, CT 06510-1825 | Controlled Substance Registration for Practitioner | 2008-09-23 ~ 2009-02-28 |
| Brent Suozzi | Suite 525, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Brent Baboolal | 21-22 29th Ave, Astoria, NY 11102-3334 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Brent J Schroeder | 171 Burritt St, Plantsville, CT 06479-1463 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Brent E Pennington Md | 10 Avalon Dr Apt 3332, Milford, CT 06460 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Brent D Wainwright Md | 247 Smith Ridge Rd, South Salem, NY 10570 | Controlled Substance Registration for Practitioner | 2006-03-28 ~ 2007-02-28 |
| Justin Brent Cohen | 999 Franklin Ave, Garden City, NY 11530-2913 | Controlled Substance Registration for Practitioner | 2017-07-07 ~ 2019-02-28 |
| Brent Cadogan | 1881 Smith St, North Providence, RI 02911-1903 | Controlled Substance Registration for Practitioner | 2019-05-06 ~ 2021-02-28 |
| Martin Ucanda | 39 Michael Rd Apt E, New London, CT 06320-2423 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Martin J Spinella | 60 Westwood Ave Ste 4, Waterbury, CT 06708-2460 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on BRENT MARTIN DDS.
| 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).