MAHYAR MAHMOUDI
Controlled Substance Registration for Practitioner


Address: 566 Dekalb Ave Apt 4g, Brooklyn, NY 11205-4999

MAHYAR MAHMOUDI (Credential# 1233958) 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

MAHYAR MAHMOUDI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0058049. 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 566 Dekalb Ave Apt 4g, Brooklyn, NY 11205-4999. The current status is inactive.

Basic Information

Licensee Name MAHYAR MAHMOUDI
Credential ID 1233958
Credential Number CSP.0058049
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 566 Dekalb Ave Apt 4g
Brooklyn
NY 11205-4999
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2014-07-23
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
1230387 1.053342 Physician/Surgeon 2014-07-22 2014-07-22 - 2015-07-31 INACTIVE

Office Location

Street Address 566 DEKALB AVE APT 4G
City BROOKLYN
State NY
Zip Code 11205-4999

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City BROOKLYN
Zip Code 11205
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BROOKLYN

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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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