DAVID C WAGGONER
Physician/surgeon


Address: 4322 General Bate Drive, Nashville, TN 37204

DAVID C WAGGONER (Credential# 557650) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is November 20, 2003. The license expiration date date is November 30, 2004. The license status is INACTIVE.

Business Overview

DAVID C WAGGONER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.040067. The credential type is physician/surgeon. The effective date is November 20, 2003. The expiration date is November 30, 2004. The business address is 4322 General Bate Drive, Nashville, TN 37204. The current status is inactive.

Basic Information

Licensee Name DAVID C WAGGONER
Credential ID 557650
Credential Number 1.040067
Credential Type Physician/Surgeon
Business Address 4322 General Bate Drive
Nashville
TN 37204
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2001-12-20
Effective Date 2003-11-20
Expiration Date 2004-11-30
Refresh Date 2009-07-08

Office Location

Street Address 4322 General Bate Drive
City Nashville
State TN
Zip Code 37204

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Matthew B Dozier 703 Berry Road, Nashville, TN 37204 Professional Engineer 2009-02-01 ~ 2010-01-31
Carolyn A Doulens 1121 Glendale Lane, Nashville, TN 37204 Certified Public Accountant License 1996-01-01 ~ 1996-12-31
Lawrence P Kleuser IIi 916 Gilmore Ave, Nashville, TN 37204 Controlled Substance Registration for Practitioner 2009-03-01 ~ 2011-02-28
Bacar Constructors Inc · Gco.00625 912 8th Avenue S, Nashville, TN 37204 Major Contractor 1996-03-04 ~ 1997-06-30
David A Pride 2613a Grissom Dr, Nashville, TN 37204 Heating, Piping & Cooling Unlimited Contractor ~
Editha Friedman 2201 8th Ave S Apt 102, Nashville, TN 37204-2245 Registered Nurse 2020-01-02 ~ 2021-01-31
Tammy R Fuller 1102 Caruthers Ave, Nashville, TN 37204-2413 Registered Nurse ~
Natalie M Campo Md 916 Gilmore Ave, Nashville, TN 37204-2613 Controlled Substance Registration for Practitioner 2010-03-12 ~ 2011-02-28
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City Nashville
Zip Code 37204
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Nashville

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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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