STEPHANIE C FASSU NOULAHEU
Controlled Substance Registration for Practitioner


Address: 184 Pequot Ave, #309, New London, CT 06320

STEPHANIE C FASSU NOULAHEU (Credential# 1121262) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.

Business Overview

STEPHANIE C FASSU NOULAHEU is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0053642. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2013. The expiration date is February 28, 2015. The business address is 184 Pequot Ave, #309, New London, CT 06320. The current status is inactive.

Basic Information

Licensee Name STEPHANIE C FASSU NOULAHEU
Credential ID 1121262
Credential Number CSP.0053642
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 184 Pequot Ave, #309
New London
CT 06320
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2012-09-10
Effective Date 2013-03-01
Expiration Date 2015-02-28
Refresh Date 2017-05-02

Other licenses

ID Credential Code Credential Type Issue Term Status
1077839 12.005102 Advanced Practice Registered Nurse 2012-08-21 2013-07-01 - 2014-06-30 INACTIVE
1077802 10.107156 Registered Nurse 2012-07-25 2013-07-01 - 2014-06-30 INACTIVE
1078208 10.106078-TEMP Registered Nurse - Temporary 2012-06-20 2012-06-20 - 2012-10-18 INACTIVE

Office Location

Street Address 184 Pequot Ave, #309
City New London
State CT
Zip Code 06320

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Competitor

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City New London
Zip Code 06320
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + New London

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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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