HENRY J GRAVEL JR
Controlled Substance Registration for Practitioner


Address: 333 Ricciuti Dr Apt 1728, Quincy, MA 02169-6396

HENRY J GRAVEL JR (Credential# 1229454) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is May 21, 2015. The license status is INACTIVE.

Business Overview

HENRY J GRAVEL JR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0057411. The credential type is controlled substance registration for practitioner. The effective date is May 21, 2015. The business address is 333 Ricciuti Dr Apt 1728, Quincy, MA 02169-6396. The current status is inactive.

Basic Information

Licensee Name HENRY J GRAVEL JR
Credential ID 1229454
Credential Number CSP.0057411
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 333 Ricciuti Dr Apt 1728
Quincy
MA 02169-6396
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2015-05-21
Refresh Date 2017-05-02

Other licenses

ID Credential Code Credential Type Issue Term Status
1228758 1 Physician/Surgeon - EXPIRED APPLICATION

Office Location

Street Address 333 RICCIUTI DR APT 1728
City QUINCY
State MA
Zip Code 02169-6396

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City QUINCY
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License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + QUINCY

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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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