JISOO SHIN DDS
Controlled Substance Registration for Practitioner


Address: 7110 Park Ave 5s, Fresh Meadows, NY 11365

JISOO SHIN DDS (Credential# 1028416) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is August 12, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.

Business Overview

JISOO SHIN DDS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0051209. The credential type is controlled substance registration for practitioner. The effective date is August 12, 2011. The expiration date is February 28, 2013. The business address is 7110 Park Ave 5s, Fresh Meadows, NY 11365. The current status is inactive.

Basic Information

Licensee Name JISOO SHIN DDS
Credential ID 1028416
Credential Number CSP.0051209
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 7110 Park Ave 5s
Fresh Meadows
NY 11365
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2011-08-12
Effective Date 2011-08-12
Expiration Date 2013-02-28
Refresh Date 2014-07-24

Other licenses

ID Credential Code Credential Type Issue Term Status
980573 2.010451 Dentist 2011-01-25 2011-09-01 - 2012-08-31 INACTIVE

Office Location

Street Address 7110 Park Ave 5S
City Fresh Meadows
State NY
Zip Code 11365

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Hai Lan Xu 6700 192nd St 1802, Fresh Meadows, NY 11365 Combination Nail Technician, Esthetician Or Eyelash Technici ~
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Hye J Lee 67-00 192st Apt 2111, Fresh Meadows, NY 11365 Combination Nail Technician, Esthetician Or Eyelash Technici ~
Qin Zhang 71-66 Parsons Blvd 4f, Fresh Meadows, NY 11365 Esthetician ~
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Competitor

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City Fresh Meadows
Zip Code 11365
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Fresh Meadows

Similar businesses

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Victor Shin Md 106 Ashling Dr, Lagrange, GA 30240 Controlled Substance Registration for Practitioner 2009-03-01 ~ 2011-02-28
Joongho Shin 30 Stevens St Ste D, Norwalk, CT 06850-3859 Controlled Substance Registration for Practitioner 2015-03-01 ~ 2017-02-28
Min Chul Shin 152 Temple St Apt 108, New Haven, CT 06510-2607 Controlled Substance Registration for Practitioner 2011-03-01 ~ 2013-02-28
Francis Shin Dds 25 Valley Drive, Greenwich, CT 06831 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
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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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