DAWN BAIRD-IMMERMAN PA-C
Controlled Substance Registration for Practitioner


Address: 23 Stonewell Dr, W Granby, CT 06090

DAWN BAIRD-IMMERMAN PA-C (Credential# 190989) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2003. The license expiration date date is February 28, 2004. The license status is INACTIVE.

Business Overview

DAWN BAIRD-IMMERMAN PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0026394. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2003. The expiration date is February 28, 2004. The business address is 23 Stonewell Dr, W Granby, CT 06090. The current status is inactive.

Basic Information

Licensee Name DAWN BAIRD-IMMERMAN PA-C
Credential ID 190989
Credential Number CSP.0026394
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 23 Stonewell Dr
W Granby
CT 06090
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2003-03-01
Expiration Date 2004-02-28
Refresh Date 2009-01-26

Other licenses

ID Credential Code Credential Type Issue Term Status
742439 23.000690 Physician Assistant 1997-12-19 2002-08-28 - 2003-05-31 INACTIVE

Office Location

Street Address 23 STONEWELL DR
City W GRANBY
State CT
Zip Code 06090

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Competitor

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City W GRANBY
Zip Code 06090
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + W GRANBY

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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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