KATIE L MACKEN
Controlled Substance Registration for Practitioner


Address: 15 Morgan Farms Dr Ste 3, South Windsor, CT 06074-1384

KATIE L MACKEN (Credential# 891660) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.

Business Overview

KATIE L MACKEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0046266. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2013. The expiration date is February 28, 2015. The business address is 15 Morgan Farms Dr Ste 3, South Windsor, CT 06074-1384. The current status is inactive.

Basic Information

Licensee Name KATIE L MACKEN
Credential ID 891660
Credential Number CSP.0046266
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 15 Morgan Farms Dr Ste 3
South Windsor
CT 06074-1384
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2009-09-09
Effective Date 2013-03-01
Expiration Date 2015-02-28
Refresh Date 2016-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
933525 2.010329 Dentist 2010-07-19 2013-07-01 - 2014-06-30 INACTIVE

Office Location

Street Address 15 MORGAN FARMS DR STE 3
City SOUTH WINDSOR
State CT
Zip Code 06074-1384

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Competitor

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City SOUTH WINDSOR
Zip Code 06074
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SOUTH WINDSOR

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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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