JENNIFER P BAUTISTA
Controlled Substance Registration for Practitioner


Address: 4 Westview Drive, Bloomfield, CT 06002

JENNIFER P BAUTISTA (Credential# 446380) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is July 26, 2010. The license expiration date date is February 28, 2011. The license status is INACTIVE.

Business Overview

JENNIFER P BAUTISTA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0039946. The credential type is controlled substance registration for practitioner. The effective date is July 26, 2010. The expiration date is February 28, 2011. The business address is 4 Westview Drive, Bloomfield, CT 06002. The current status is inactive.

Basic Information

Licensee Name JENNIFER P BAUTISTA
Credential ID 446380
Credential Number CSP.0039946
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 4 Westview Drive
Bloomfield
CT 06002
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2006-09-13
Effective Date 2010-07-26
Expiration Date 2011-02-28
Refresh Date 2013-03-07

Office Location

Street Address 4 WESTVIEW DRIVE
City BLOOMFIELD
State CT
Zip Code 06002

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Competitor

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City BLOOMFIELD
Zip Code 06002
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BLOOMFIELD

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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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