MEREDITH FAGGEN
Controlled Substance Registration for Practitioner


Address: 125 Prospect St #12, Providence, RI 02906

MEREDITH FAGGEN (Credential# 374260) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2008. The license expiration date date is February 28, 2009. The license status is INACTIVE.

Business Overview

MEREDITH FAGGEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0035212. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2008. The expiration date is February 28, 2009. The business address is 125 Prospect St #12, Providence, RI 02906. The current status is inactive.

Basic Information

Licensee Name MEREDITH FAGGEN
Credential ID 374260
Credential Number CSP.0035212
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 125 Prospect St #12
Providence
RI 02906
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2004-07-15
Effective Date 2008-03-01
Expiration Date 2009-02-28
Refresh Date 2011-01-12

Office Location

Street Address 125 PROSPECT ST #12
City PROVIDENCE
State RI
Zip Code 02906

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Competitor

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City PROVIDENCE
Zip Code 02906
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PROVIDENCE

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Meredith G Faggen 125 Prospect Street, Providence, RI 02906 Physician/surgeon 2008-03-24 ~ 2009-04-30
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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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