KYLE D PRUETT MD
Controlled Substance Registration for Practitioner


Address: 57 Gothic St, Northampton, MA 01060-3047

KYLE D PRUETT MD (Credential# 147778) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.

Business Overview

KYLE D PRUETT MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0007816. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 57 Gothic St, Northampton, MA 01060-3047. The current status is active.

Basic Information

Licensee Name KYLE D PRUETT MD
Credential ID 147778
Credential Number CSP.0007816
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 57 Gothic St
Northampton
MA 01060-3047
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 1999-03-01
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2018-12-28

Other licenses

ID Credential Code Credential Type Issue Term Status
541630 1.015783 Physician/Surgeon 1972-10-19 2019-09-01 - 2020-08-31 ACTIVE

Office Location

Street Address 57 GOTHIC ST
City NORTHAMPTON
State MA
Zip Code 01060-3047

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Competitor

Search similar business entities

City NORTHAMPTON
Zip Code 01060
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NORTHAMPTON

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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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