BRUCE M BRENNER (Credential# 443846) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
BRUCE M BRENNER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0039488. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 263 Farmington Ave, Farmington, CT 06030-3955. The current status is lapsed.
| Licensee Name | BRUCE M BRENNER |
| Credential ID | 443846 |
| Credential Number | CSP.0039488 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
263 Farmington Ave Farmington CT 06030-3955 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2006-07-12 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 562079 | 1.044497 | Physician/Surgeon | 2006-06-20 | 2017-05-01 - 2018-04-30 | INACTIVE |
| Street Address | 263 FARMINGTON AVE |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-3955 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Erica Shen Nofziger | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2027-06-30 |
| Matthew D Goranson | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2026-06-30 |
| Jacob Silver | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Nicholas Bellas | 263 Farmington Ave, Farmington, CT 06032-1956 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Jennifer Hale | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Cory R Hewitt | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Sango Huwaa Mosia Asante | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Ryan Desrochers | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Kelsey D Greenhalgh | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Dentist | 2019-07-01 ~ 2025-06-30 |
| Derek J Tow | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Dentist | 2019-07-01 ~ 2025-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Adam T. Tyson | 263 Farmington Ave Mc-3955, Farmington, CT 06030-3955 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Xuan M Luu Md | 263 Farmington Avenue Mc-3955, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2013-06-07 ~ 2015-02-28 |
| Andrew S Nisbet | 262 Farmington Avenue Mc-3955, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Alisa M.d. Berger | 263 Farmington Ave Mc 3955, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2007-03-28 ~ 2008-02-29 |
| Carl K Gjertson | Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Peter C Albertsen | Uconn Health Center, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael S Dahn Md | Uconn Health Ctr, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Kiranmayi Muddasani | 263 Farmington Ave Mc-3955, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2013-04-26 ~ 2015-02-28 |
| Jeffrey Wu | 263 Farmington Ave Mc-3955, Farmington, CT 06030-3955 | Physician/surgeon | 2012-10-25 ~ 2013-07-31 |
| Sarah D Treter | 263 Farmington Ave Mc-3955, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2011-06-15 ~ 2013-02-28 |
| Find all Licenses in zip 06030-3955 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | FARMINGTON |
| Zip Code | 06030 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Bethaney B Brenner | 8 Milford St, Burlington, CT 06013 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lois M Brenner Pa-c | 12 East 86 St Apt 1230, New York, NY 10028 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Cary Brenner | 147 Grassy Plain St, Bethel, CT 06801-2806 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| John G Brenner | 2112 Avalon Dr, Shelton, CT 06484-4462 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Bruce Y Cha | 60 Washington Ave., Hamden, CT 06518 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Bruce R Little Md | 28 Russell St, Litchfield, CT 06759 | Controlled Substance Registration for Practitioner | 1997-03-18 ~ 1998-02-28 |
| Bruce Schoolcraft Do | Po Box 549, Hardwick, GA 31034-0549 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Bruce T Lyman Md | Po Box 214, Woodstock, CT 06281-0214 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Bruce M Cudd Pa | Rr 1, Walpole, NH 03608 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
| Bruce M Mcdonald | 74 Hamilton Ct, Fairfield, CT 06824-7831 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on BRUCE M BRENNER.
| 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).