MARYAM TAHVILDARI
Controlled Substance Registration for Practitioner


Address: 130 Division St, Derby, CT 06418-1326

MARYAM TAHVILDARI (Credential# 1361059) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.

Business Overview

MARYAM TAHVILDARI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0063182. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 130 Division St, Derby, CT 06418-1326. The current status is lapsed.

Basic Information

Licensee Name MARYAM TAHVILDARI
Credential ID 1361059
Credential Number CSP.0063182
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 130 Division St
Derby
CT 06418-1326
Business Type INDIVIDUAL
Status LAPSED
Active 1
Issue Date 2016-06-17
Effective Date 2017-03-01
Expiration Date 2019-02-28
Refresh Date 2019-03-06

Office Location

Street Address 130 DIVISION ST
City DERBY
State CT
Zip Code 06418-1326

Licenses in the same location

Licensee Name Office Address Credential Effective / Expiration
Ricardo Concepcion Gomez 130 Division St, Derby, CT 06418-1326 Resident Physician 2020-07-01 ~ 2024-06-30
Anwesh Poosala 130 Division St, Derby, CT 06418-1326 Resident Physician 2020-07-01 ~ 2024-06-30
Da Young Ryu 130 Division St, Derby, CT 06418 Resident Physician 2020-07-01 ~ 2024-06-30
Genevieve C Kela 130 Division St, Derby, CT 06418-1326 Resident Physician 2020-07-01 ~ 2023-06-30
Inshiya Dawoodi 130 Division St, Derby, CT 06418-1326 Resident Physician 2020-07-01 ~ 2023-06-30
Sovit Dahal 130 Division St, Derby, CT 06418-1326 Resident Physician 2020-07-01 ~ 2023-06-30
Rosa Constantino 130 Division St, Derby, CT 06418-1326 Resident Physician 2020-07-01 ~ 2023-06-30
Ivanshi Gondalia 130 Division St, Derby, CT 06418-1326 Resident Physician 2020-07-01 ~ 2023-06-30
Angad Gill 130 Division St, Derby, CT 06418-1326 Resident Physician 2020-07-01 ~ 2023-06-30
Douglas Palacios 130 Division St, Derby, CT 06418-1326 Resident Physician 2020-07-01 ~ 2023-06-30
Find all Licenses in the same address

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Kathleen M Chaisson Md 130 Division St # I, Derby, CT 06418-1326 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Turn The Tide Foundation Inc 130 Division St Fl 2, Derby, CT 06418-1326 Public Charity 2017-12-01 ~ 2018-11-30

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Debra A Montini 8 Academy Hill Ext, Derby, CT 06418 Dental Hygienist 2020-08-01 ~ 2021-07-31
Laura M Boanno 131 Marshall La, Derby, CT 06418 Registered Nurse 2020-07-01 ~ 2021-06-30
Danyun Chen 49 Pershing Dr., Derby, CT 06418 Combination Nail Technician, Esthetician Or Eyelash Technici ~
Fan Geng Shoprite Shopping Center, Derby, CT 06418 Combination Nail Technician, Esthetician Or Eyelash Technici ~
Danni Xu Shoprite Shopping Center49 Pershing Dr, Derby, CT 06418 Combination Nail Technician, Esthetician Or Eyelash Technici ~
Yao Zhang Shoprite Shopping Center 49 Pershing Dr, Derby, CT 06418 Combination Nail Technician, Esthetician Or Eyelash Technici ~
Phillip N Burke 3 Camptown St, Derby, CT 06418 Emergency Medical Technician 2017-06-07 ~ 2020-06-30
Diane A Rosner 229 Shagbark Drive, Derby, CT 06418 Professional Counselor 2020-08-01 ~ 2021-07-31
Pamela C Lavelle 194 Minerva St, Derby, CT 06418 Registered Nurse 2020-08-01 ~ 2021-07-31
Grade A Market - Derby LLC 49 Pershing Dr, Derby, CT 06418 Operator of Weighing & Measuring Devices 2020-08-01 ~ 2021-07-31
Find all Licenses in zip 06418

Competitor

Search similar business entities

City DERBY
Zip Code 06418
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + DERBY

Similar businesses

Licensee Name Office Address Credential Effective / Expiration
Maryam Rostami Dds 207 George St Apt 516, Middletown, CT 06457-6701 Controlled Substance Registration for Practitioner 2013-03-01 ~ 2015-02-28
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Maryam Dastrange Sammet 56 Franklin St, Waterbury, CT 06706-1253 Controlled Substance Registration for Practitioner 2015-03-01 ~ 2017-02-28
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Maryam Hedayatzadeh Md Womens Healthcare of New England, Norwalk, CT 06851 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Maryam Etesami Po Box 208042, Yale Medicine, New Haven, CT 06520-8042 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Maryam Edalat Dds 420 Easr 58th Street, New York City, NY 10022 Controlled Substance Registration for Practitioner 2000-02-29 ~ 2001-02-28
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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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