ANSELM WONG MD
Physician/surgeon


Address: 38 Republic Dr Apt 129, Bloomfield, CT 06002-5465

ANSELM WONG MD (Credential# 915081) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2012. The license expiration date date is August 31, 2013. The license status is PENDING.

Business Overview

ANSELM WONG MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.048907. The credential type is physician/surgeon. The effective date is September 1, 2012. The expiration date is August 31, 2013. The business address is 38 Republic Dr Apt 129, Bloomfield, CT 06002-5465. The current status is pending.

Basic Information

Licensee Name ANSELM WONG MD
Credential ID 915081
Credential Number 1.048907
Credential Type Physician/Surgeon
Business Address 38 Republic Dr Apt 129
Bloomfield
CT 06002-5465
Business Type INDIVIDUAL
Status PENDING - REINSTATEMENT APPLICATION PENDING
Issue Date 2010-06-15
Effective Date 2012-09-01
Expiration Date 2013-08-31
Refresh Date 2015-06-08

Other licenses

ID Credential Code Credential Type Issue Term Status
944414 CSP.0048103 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2010-08-17 2011-03-01 - 2013-02-28 INACTIVE

Office Location

Street Address 38 REPUBLIC DR APT 129
City BLOOMFIELD
State CT
Zip Code 06002-5465

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Taylor A West 5 Tiffany Ln, Bloomfield, CT 06002 Registered Nurse 2020-07-01 ~ 2021-06-30
Emma J Ranel 53 Burr Road, Bloomfield, CT 06002 Licensed Practical Nurse 2020-07-01 ~ 2021-06-30
Dorothy W Field 177 Oliver Way, Bloomfield, CT 06002 Registered Nurse 2020-09-01 ~ 2021-08-31
Carol J Mortensen 6 Maple Edge Dr, Bloomfield, CT 06002 Registered Nurse 2020-07-01 ~ 2021-06-30
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Competitor

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City BLOOMFIELD
Zip Code 06002
License Type Physician/Surgeon
License Type + County Physician/Surgeon + BLOOMFIELD

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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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