Connecticut
Department of Consumer Protection
SHANNON BLAKE
Controlled Substance Registration for Practitioners
License number
CSP.0042665
Date granted
03/01/2013
Date expires
02/28/2015
Class
Controlled Substance Registration for Practitioners
Status
Active
Address
MANCHESTER, CT, 06042
ctlicensing.org
ID 350912
LAST UPDATED 2024-04-19 21:50:16 UTC
LAST UPDATED 2024-04-19 21:50:16 UTC
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