ASEFEH FARAZ APRN
Controlled Substance Registration for Practitioner


Address: 3000 City Walk Way Apt 305, Charlottesville, VA 22902-5546

ASEFEH FARAZ APRN (Credential# 1033554) 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

ASEFEH FARAZ APRN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0051415. 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 3000 City Walk Way Apt 305, Charlottesville, VA 22902-5546. The current status is inactive.

Basic Information

Licensee Name ASEFEH FARAZ APRN
Credential ID 1033554
Credential Number CSP.0051415
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 3000 City Walk Way Apt 305
Charlottesville
VA 22902-5546
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2011-09-19
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
585165 10.081163 Registered Nurse 2007-03-14 2015-10-01 - 2016-09-30 INACTIVE
948259 12.004520 Advanced Practice Registered Nurse 2010-10-14 2015-10-01 - 2016-09-30 INACTIVE
951146 10-TEMP Registered Nurse - Temporary - PENDING

Office Location

Street Address 3000 CITY WALK WAY APT 305
City CHARLOTTESVILLE
State VA
Zip Code 22902-5546

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Lorna L Walker Lewis & Clark Square #702, Charlottesville, VA 22902 Real Estate Broker 2003-04-01 ~ 2004-03-31
Kluge Estate Winery & Vineyard 100 Grand Cru Drive, Charlottesville, VA 22902 Out of State Winery 2010-09-04 ~ 2011-09-03
Kevin T Burke 700 East Jefferson St, Charlottesville, VA 22902 Architect 2011-02-08 ~ 2011-07-31
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Catherine J Clark 1480 Willow Lake Dr, Charlottesville, VA 22902 Occupational Therapist ~ 1999-07-31
Marc K Burkard 1687 Royal Oak Court, Charlottesville, VA 22902 Physical Therapist 2003-08-25 ~ 2004-10-31
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Competitor

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City CHARLOTTESVILLE
Zip Code 22902
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + CHARLOTTESVILLE

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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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