GUIRLAINE BLOT SANON
Controlled Substance Registration for Practitioner


Address: 138 Delaware Ave, Freeport, NY 11520-1313

GUIRLAINE BLOT SANON (Credential# 1121260) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.

Business Overview

GUIRLAINE BLOT SANON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0053641. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 138 Delaware Ave, Freeport, NY 11520-1313. The current status is lapsed.

Basic Information

Licensee Name GUIRLAINE BLOT SANON
Credential ID 1121260
Credential Number CSP.0053641
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 138 Delaware Ave
Freeport
NY 11520-1313
Business Type INDIVIDUAL
Status LAPSED
Active 1
Issue Date 2012-11-02
Effective Date 2017-03-01
Expiration Date 2019-02-28
Refresh Date 2019-03-06

Other licenses

ID Credential Code Credential Type Issue Term Status
1120890 1.051458-DO Physician/Surgeon 2012-11-01 2015-12-01 - 2016-11-30 INACTIVE

Office Location

Street Address 138 DELAWARE AVE
City FREEPORT
State NY
Zip Code 11520-1313

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Competitor

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City FREEPORT
Zip Code 11520
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FREEPORT

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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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