Jacqueline P Talbot Pa Controlled Substance Registration for Practitioner
22 Woodridge Ln, New Fairfield, CT 068125033


Jacqueline P Talbot Pa is licensed in the eLicensing system of Connecticut. The license credential ID is 413962. The license type is CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER. The license status is ACTIVE. The address is 22 Woodridge Ln, New Fairfield, CT 068125033. The zip code is 06812.


Jacqueline P Talbot Pa · 22 Woodridge Ln, New Fairfield, CT 068125033

Credential ID 413962
Name JACQUELINE P TALBOT PA
Type INDIVIDUAL
Address 22 WOODRIDGE LN
NEW FAIRFIELD, CT 068125033
License Credential CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Full Credential Code CSP.0038047
Credential Type CSP
Credential Number 38047
Status ACTIVE
Status Reason CURRENT
Active 1
Issue Date 08/22/2005
Effective Date 03/01/2015
Expiration Date 02/28/2017
Record Refresh Date 02/13/201

street_number: 22
route: Woodridge Lane (Woodridge Ln)
locality, political: New Fairfield
admin_level_2, political: Fairfield County
admin_level_1, political: Connecticut (CT)
country, political: United States (US)
postal_code: 06812
postal_code_suffix: 5033
types : street_address
latitude: 41.4553163
longitude: -73.4719732
latlng: (41.4553163, -73.4719732)


JACQUELINE P TALBOT PA · Connecticut Business

Jacqueline P Talbot Pa · Physician Assistant 22 Woodridge Ln, New Fairfield, CT 068125033

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