JORDAN J. WONG
Controlled Substance Registration for Practitioner


Address: 204-14 26th Ave., Bayside, NY 11360

JORDAN J. WONG (Credential# 907556) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.

Business Overview

JORDAN J. WONG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0047057. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2011. The expiration date is February 28, 2013. The business address is 204-14 26th Ave., Bayside, NY 11360. The current status is inactive.

Basic Information

Licensee Name JORDAN J. WONG
Credential ID 907556
Credential Number CSP.0047057
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 204-14 26th Ave.
Bayside
NY 11360
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2009-12-15
Effective Date 2011-03-01
Expiration Date 2013-02-28
Refresh Date 2014-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
904653 23.002362 Physician Assistant 2009-12-10 2012-03-01 - 2013-02-28 INACTIVE

Office Location

Street Address 204-14 26TH AVE.
City BAYSIDE
State NY
Zip Code 11360

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City BAYSIDE
Zip Code 11360
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BAYSIDE

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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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