SOPHIA KICIUK
Controlled Substance Registration for Practitioner


Address: 11 Yale Pl, Armonk, NY 10504-2424

SOPHIA KICIUK (Credential# 1377320) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is September 3, 2016. The license expiration date date is February 28, 2017. The license status is INACTIVE.

Business Overview

SOPHIA KICIUK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0063959. The credential type is controlled substance registration for practitioner. The effective date is September 3, 2016. The expiration date is February 28, 2017. The business address is 11 Yale Pl, Armonk, NY 10504-2424. The current status is inactive.

Basic Information

Licensee Name SOPHIA KICIUK
Credential ID 1377320
Credential Number CSP.0063959
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 11 Yale Pl
Armonk
NY 10504-2424
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2016-09-03
Effective Date 2016-09-03
Expiration Date 2017-02-28
Refresh Date 2018-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
1368611 12.006675 Advanced Practice Registered Nurse 2016-08-15 2016-08-15 - 2017-02-28 INACTIVE
1368429 10.136339 Registered Nurse 2016-08-15 2016-08-15 - 2017-02-28 INACTIVE

Office Location

Street Address 11 YALE PL
City ARMONK
State NY
Zip Code 10504-2424

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Competitor

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City ARMONK
Zip Code 10504
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + ARMONK

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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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