NICOLE A LANG
Controlled Substance Registration for Practitioner


Address: 500 E Main St Ste 212, Branford, CT 06405-2920

NICOLE A LANG (Credential# 501152) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.

Business Overview

NICOLE A LANG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0043426. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2015. The expiration date is February 28, 2017. The business address is 500 E Main St Ste 212, Branford, CT 06405-2920. The current status is inactive.

Basic Information

Licensee Name NICOLE A LANG
Credential ID 501152
Credential Number CSP.0043426
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 500 E Main St Ste 212
Branford
CT 06405-2920
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2008-08-26
Effective Date 2015-03-01
Expiration Date 2017-02-28
Refresh Date 2018-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
974346 1.049344-DO Physician/Surgeon 2010-11-16 2015-07-01 - 2016-06-30 INACTIVE

Office Location

Street Address 500 E MAIN ST STE 212
City BRANFORD
State CT
Zip Code 06405-2920

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Competitor

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City BRANFORD
Zip Code 06405
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRANFORD

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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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