MAYA T KHOUKAZ
Controlled Substance Registration for Practitioner


Address: 2312 Elliston Place Apt 441, Nashville, TN 37203

MAYA T KHOUKAZ (Credential# 1026539) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.

Business Overview

MAYA T KHOUKAZ is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0051095. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2015. The expiration date is February 28, 2017. The business address is 2312 Elliston Place Apt 441, Nashville, TN 37203. The current status is inactive.

Basic Information

Licensee Name MAYA T KHOUKAZ
Credential ID 1026539
Credential Number CSP.0051095
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 2312 Elliston Place Apt 441
Nashville
TN 37203
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2011-08-16
Effective Date 2015-03-01
Expiration Date 2017-02-28
Refresh Date 2018-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
1067746 1.051516 Physician/Surgeon 2012-12-03 2014-11-01 - 2015-10-31 INACTIVE

Office Location

Street Address 2312 Elliston Place Apt 441
City Nashville
State TN
Zip Code 37203

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Competitor

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City Nashville
Zip Code 37203
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Nashville

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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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