Connecticut
Department of Consumer Protection
MARY FORMAN
Controlled Substance Registration for Practitioners
License number
CSP.0046978
Date granted
03/01/2013
Date expires
02/28/2015
Class
Controlled Substance Registration for Practitioners
Status
Active
Address
LITCHFIELD, CT, 06759-3721
ctlicensing.org
ID 348539
LAST UPDATED 2024-04-22 04:40:33 UTC
LAST UPDATED 2024-04-22 04:40:33 UTC
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