MARK A BLUMENFELD
Controlled Substance Registration for Practitioner


Address: 100 Casterbridge Xing Unit 105, Simsbury, CT 06070-1487

MARK A BLUMENFELD (Credential# 151765) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is January 17, 2019. The license expiration date date is February 28, 2019. The license status is RETIRED.

Business Overview

MARK A BLUMENFELD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0010176. The credential type is controlled substance registration for practitioner. The effective date is January 17, 2019. The expiration date is February 28, 2019. The business address is 100 Casterbridge Xing Unit 105, Simsbury, CT 06070-1487. The current status is retired.

Basic Information

Licensee Name MARK A BLUMENFELD
Credential ID 151765
Credential Number CSP.0010176
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 100 Casterbridge Xing Unit 105
Simsbury
CT 06070-1487
Business Type INDIVIDUAL
Status RETIRED - NOT ACTIVELY ENGAGING
Active 1
Issue Date 1999-02-28
Effective Date 2019-01-17
Expiration Date 2019-02-28
Refresh Date 2019-01-17

Other licenses

ID Credential Code Credential Type Issue Term Status
542458 1.017586 Physician/Surgeon 1976-03-15 2017-03-01 - 2018-02-28 INACTIVE

Office Location

Street Address 100 CASTERBRIDGE XING UNIT 105
City SIMSBURY
State CT
Zip Code 06070-1487

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Competitor

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City SIMSBURY
Zip Code 06070
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SIMSBURY

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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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