Mark T Lopez Od Controlled Substance Registration for Practitioner
1026 Long Cove Rd, Gales Ferry, CT 06335


Mark T Lopez Od is licensed in the eLicensing system of Connecticut. The license credential ID is 128236. The license type is CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER. The license status is ACTIVE. The address is 1026 Long Cove Rd, Gales Ferry, CT 06335. The zip code is 06335.


Mark T Lopez Od · 1026 Long Cove Rd, Gales Ferry, CT 06335

Credential ID 128236
Name MARK T LOPEZ OD
Type INDIVIDUAL
Address 1026 LONG COVE RD
GALES FERRY, CT 06335
License Credential CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Full Credential Code CSP.0026405
Credential Type CSP
Credential Number 26405
Status ACTIVE
Status Reason CURRENT
Active 1
Effective Date 03/01/2015
Expiration Date 02/28/2017
Record Refresh Date 02/23/201

MARK T LOPEZ OD · Connecticut Business

Mark T Lopez Od · Optometrist 1026 Long Cove Rd, Gales Ferry, CT 06335

Zip 06335 · Controlled Substance Registration for Practitioner · Connecticut Business

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