SEAN A GHASSEM-ZADEH
Dentist


Address: 19 Timberline Dr, Farmington, CT 06032-1745

SEAN A GHASSEM-ZADEH (Credential# 1305016) is licensed (Dentist) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2016. The license expiration date date is May 31, 2017. The license status is INACTIVE.

Business Overview

SEAN A GHASSEM-ZADEH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #2.011487. The credential type is dentist. The effective date is June 1, 2016. The expiration date is May 31, 2017. The business address is 19 Timberline Dr, Farmington, CT 06032-1745. The current status is inactive.

Basic Information

Licensee Name SEAN A GHASSEM-ZADEH
Credential ID 1305016
Credential Number 2.011487
Credential Type Dentist
Business Address 19 Timberline Dr
Farmington
CT 06032-1745
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2015-08-19
Effective Date 2016-06-01
Expiration Date 2017-05-31
Refresh Date 2017-09-03

Other licenses

ID Credential Code Credential Type Issue Term Status
1235004 CSP.0058161 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2014-07-22 2015-03-01 - 2017-02-28 INACTIVE

Office Location

Street Address 19 TIMBERLINE DR
City FARMINGTON
State CT
Zip Code 06032-1745

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Lindsey W Howard 7 Timberline Dr, Farmington, CT 06032-1745 Licensed Clinical Social Worker 2020-01-01 ~ 2020-12-31
Peter C Lam 25 Timberline Dr, Farmington, CT 06032-1745 Resident Physician 2017-06-28 ~ 2021-06-30

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Competitor

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City FARMINGTON
Zip Code 06032
License Type Dentist
License Type + County Dentist + FARMINGTON

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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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