THOMAS J WAGNER (Credential# 190171) 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.
THOMAS J WAGNER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0026459. 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 540 Route 148, Killingworth, CT 06419. The current status is active.
| Licensee Name | THOMAS J WAGNER |
| Credential ID | 190171 |
| Credential Number | CSP.0026459 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
540 Route 148 Killingworth CT 06419 |
| 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 | 2019-02-20 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 762911 | 3.002282 | Optometrist | 1990-09-11 | 2019-12-01 - 2020-11-30 | ACTIVE |
| Street Address | 540 ROUTE 148 |
| City | KILLINGWORTH |
| State | CT |
| Zip Code | 06419 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patricia A Wagner | 540 Route 148, Killingworth, CT 06419 | Notary Public Appointment | 2017-03-01 ~ 2022-02-28 |
| Holly A Bonfoey | 540 Route 148, Killingworth, CT 06419-1107 | Hairdresser/cosmetician | 2019-02-01 ~ 2021-01-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rajendra K Bobba | 39 Buell Hill Rd, Killingworth, CT 06419 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Deborah M Cabral | 61 Little Cty Rd, Killingworth, CT 06419 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Cheryl Dickson Toman | 16 Cedar Drive, Killingworth, CT 06419 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Nanci S Coleman | 9 Buell Hill Rd., Killingworth, CT 06419 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Sondra D Arbona | 21 Robin Ln, Killingworth, CT 06419 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Lisa R Barbour | 32 Boulder Trail, Killingworth, CT 06419 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Barbara K Irzyk | 12 Warwickshire Dr., Killingworth, CT 06419 | Speech and Language Pathologist | 2020-09-01 ~ 2021-08-31 |
| Diane Shauk Shuir | 184 Route 81 Bldg2, Killingworth, CT 06419 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-20 ~ 2022-05-31 |
| Yvonne Bradley | 42 Fawn Hill Road, Killingworth, CT 06419 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Staci L Petroskey | 140 Little City Road, Killingworth, CT 06419 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06419 | |||
| City | KILLINGWORTH |
| Zip Code | 06419 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + KILLINGWORTH |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brian K Wagner | 11 South Rd, Farmington, CT 06032-2483 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jessica L Wagner | 227 Church St Apt 7c, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Krystn R Wagner | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Todd L Wagner Do | 40 Middlefield St, Groton Long Pt, CT 06340 | Controlled Substance Registration for Practitioner | ~ 2001-02-28 |
| Matthew P Wagner | 1450 Chapel St, New Haven, CT 06511-4405 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Joseph R Wagner Md | 85 Seymour St Suite 416, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Peter John Wagner | 162 Dawley Dr., Stonington, CT 06378 | Controlled Substance Registration for Practitioner | 2019-04-02 ~ 2021-02-28 |
| Annette V Wagner Md | 7 Niagara Pier, Erie, PA 16507 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Cliff Wagner Md | 161 Talcott Notch Rd, Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| James L. Wagner | 1608 Riverview Rd, Chattanooga, TN 37405-3131 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
Please comment or provide details below to improve the information on THOMAS J WAGNER.
| 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).