AZRA KHAN SALAHUDDIN
Physician/surgeon


Address: 41 Brewster Rd., Bristol, CT 06010

AZRA KHAN SALAHUDDIN (Credential# 1425607) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2018. The license expiration date date is June 30, 2019. The license status is INACTIVE.

Business Overview

AZRA KHAN SALAHUDDIN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.056578. The credential type is physician/surgeon. The effective date is July 1, 2018. The expiration date is June 30, 2019. The business address is 41 Brewster Rd., Bristol, CT 06010. The current status is inactive.

Basic Information

Licensee Name AZRA KHAN SALAHUDDIN
Credential ID 1425607
Credential Number 1.056578
Credential Type Physician/Surgeon
Business Address 41 Brewster Rd.
Bristol
CT 06010
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2017-06-20
Effective Date 2018-07-01
Expiration Date 2019-06-30
Refresh Date 2019-10-03

Other licenses

ID Credential Code Credential Type Issue Term Status
1425831 CSP.0065561 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2017-06-21 2017-06-21 - 2019-02-28 LAPSED

Office Location

Street Address 41 Brewster Rd.
City Bristol
State CT
Zip Code 06010

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Competitor

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City Bristol
Zip Code 06010
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Bristol

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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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