JONATHAN G GREENWALD
Controlled Substance Registration for Practitioner


Address: 14 Crawford Rd, Westport, CT 06880-1822

JONATHAN G GREENWALD (Credential# 153698) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 10, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.

Business Overview

JONATHAN G GREENWALD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0005683. The credential type is controlled substance registration for practitioner. The effective date is March 10, 2017. The expiration date is February 28, 2019. The business address is 14 Crawford Rd, Westport, CT 06880-1822. The current status is lapsed.

Basic Information

Licensee Name JONATHAN G GREENWALD
Credential ID 153698
Credential Number CSP.0005683
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 14 Crawford Rd
Westport
CT 06880-1822
Business Type INDIVIDUAL
Status LAPSED
Active 1
Issue Date 1999-03-02
Effective Date 2017-03-10
Expiration Date 2019-02-28
Refresh Date 2019-03-06

Other licenses

ID Credential Code Credential Type Issue Term Status
540397 1.012566 Physician/Surgeon 1966-05-25 2017-06-01 - 2018-05-31 INACTIVE

Office Location

Street Address 14 CRAWFORD RD
City WESTPORT
State CT
Zip Code 06880-1822

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Competitor

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City WESTPORT
Zip Code 06880
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WESTPORT

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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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