MALCOLM GORDON MD (Credential# 153426) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.
MALCOLM GORDON MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0012716. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2015. The expiration date is February 28, 2017. The business address is 38 Harborview Ave, Norwalk, CT 06854. The current status is inactive.
| Licensee Name | MALCOLM GORDON MD |
| Credential ID | 153426 |
| Credential Number | CSP.0012716 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
38 Harborview Ave Norwalk CT 06854 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 2015-03-01 |
| Expiration Date | 2017-02-28 |
| Refresh Date | 2018-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 545719 | 1.025912 | Physician/Surgeon | 1984-09-05 | 2015-11-01 - 2016-10-31 | INACTIVE |
| Street Address | 38 HARBORVIEW AVE |
| City | NORWALK |
| State | CT |
| Zip Code | 06854 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Vanessa Benitez | 190 Ely Ave., Norwalk, CT 06854 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jessica Christina Andraszek | 7a Edgewood St, Norwalk, CT 06854 | Registered Nurse | ~ |
| Farrah Marin | 63 Bayview Avenue, Norwalk, CT 06854 | Master's Level Social Worker | ~ |
| Irma M Ross | 30 Lenox Ave, Norwalk, CT 06854 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Community Plates Inc. | 165 Water Street, Norwalk, CT 06854 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Roberto Arzuaga · West Cedar Grocery | 155 West Cedar St, Norwalk, CT 06854 | Grocery Beer | 2020-07-17 ~ 2021-07-16 |
| Faith Kiriakidis | 130 Flax Hill Road, Norwalk, CT 06854 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Andrew Gotlin | 1 North Water Street, Norwalk, CT 06854 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Shunxia Guan | 360 Connecticut Ste 2, Norwalk, CT 06854 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Zhenyu Quan | 360 Connecticut Ave Suit 2, Norwalk, CT 06854 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Find all Licenses in zip 06854 | |||
| City | NORWALK |
| Zip Code | 06854 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NORWALK |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jessica A Malcolm | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-06-05 ~ 2021-02-28 |
| Malcolm B Friedman | 35 Canterbury Rd., Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Malcolm L Whitman Dds | 56 George St, Mendon, MA 01756-1138 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Malcolm S Roth | 33 Saddle Ridge, Bloomfield, CT 06002 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Sikandar Z Khan | 470 Malcolm X Blvd Apt 9t, New York, NY 10037-3026 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Kelly Jarrett | 380 Malcolm X Blvd, New York, NY 10027 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tunesia L Mitchell | 470 Malcolm X Blvd Apt 2g, New York, NY 10037-3012 | Controlled Substance Registration for Practitioner | 2009-10-20 ~ 2011-02-28 |
| Malcolm Gourlie Md | 27 William F Palmer Rd, Moodus, CT 06469-1131 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sarah Masoodsinaki | 470 Malcolm X Blvd Apt 14m, New York, NY 10037-3034 | Controlled Substance Registration for Practitioner | 2015-07-08 ~ 2017-02-28 |
| Malcolm R Freedman | 6440 Bigelow Commons, Enfield, CT 06082 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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| 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).