AYANNA V BUCKNER MD
Physician/surgeon


Address: 207 High Top Circle West, Hamden, CT 06514

AYANNA V BUCKNER MD (Credential# 559349) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is February 25, 2005. The license expiration date date is February 28, 2006. The license status is INACTIVE.

Business Overview

AYANNA V BUCKNER MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.041766. The credential type is physician/surgeon. The effective date is February 25, 2005. The expiration date is February 28, 2006. The business address is 207 High Top Circle West, Hamden, CT 06514. The current status is inactive.

Basic Information

Licensee Name AYANNA V BUCKNER MD
Credential ID 559349
Credential Number 1.041766
Credential Type Physician/Surgeon
Business Address 207 High Top Circle West
Hamden
CT 06514
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2003-08-12
Effective Date 2005-02-25
Expiration Date 2006-02-28
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
374989 CSP.0035279 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2004-07-16 2005-03-01 - 2006-02-28 INACTIVE

Office Location

Street Address 207 HIGH TOP CIRCLE WEST
City HAMDEN
State CT
Zip Code 06514

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Kimberly S Traverso 50 Building Brook Road, Hamden, CT 06514 Professional Counselor 2020-08-01 ~ 2021-07-31
Kevin A Guess 3rd Street, Hamden, CT 06514 Public Weigher 2020-06-12 ~ 2021-06-30
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Competitor

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City HAMDEN
Zip Code 06514
License Type Physician/Surgeon
License Type + County Physician/Surgeon + HAMDEN

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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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