FARBOD RAISZADEH
Controlled Substance Registration for Practitioner


Address: 1795 Riverside Dr Apt 2a, New York, NY 10034-5366

FARBOD RAISZADEH (Credential# 1197458) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is December 7, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.

Business Overview

FARBOD RAISZADEH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0056466. The credential type is controlled substance registration for practitioner. The effective date is December 7, 2013. The expiration date is February 28, 2015. The business address is 1795 Riverside Dr Apt 2a, New York, NY 10034-5366. The current status is inactive.

Basic Information

Licensee Name FARBOD RAISZADEH
Credential ID 1197458
Credential Number CSP.0056466
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 1795 Riverside Dr Apt 2a
New York
NY 10034-5366
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2013-12-07
Effective Date 2013-12-07
Expiration Date 2015-02-28
Refresh Date 2017-05-02

Other licenses

ID Credential Code Credential Type Issue Term Status
1188706 1.052519 Physician/Surgeon 2013-10-17 2013-10-17 - 2014-06-30 INACTIVE

Office Location

Street Address 1795 RIVERSIDE DR APT 2A
City NEW YORK
State NY
Zip Code 10034-5366

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City NEW YORK
Zip Code 10034
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW YORK

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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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