HERMAN AUSTRIAN MD
Controlled Substance Registration for Practitioner


Address: 69 Gate Ridge Rd, Fairfield, CT 06432-1170

HERMAN AUSTRIAN MD (Credential# 153917) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2003. The license expiration date date is February 28, 2004. The license status is INACTIVE.

Business Overview

HERMAN AUSTRIAN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0015834. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2003. The expiration date is February 28, 2004. The business address is 69 Gate Ridge Rd, Fairfield, CT 06432-1170. The current status is inactive.

Basic Information

Licensee Name HERMAN AUSTRIAN MD
Credential ID 153917
Credential Number CSP.0015834
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 69 Gate Ridge Rd
Fairfield
CT 06432-1170
Business Type INDIVIDUAL
Status INACTIVE - SURRENDERED
Effective Date 2003-03-01
Expiration Date 2004-02-28
Refresh Date 2004-04-23

Other licenses

ID Credential Code Credential Type Issue Term Status
539110 1.008255 Physician/Surgeon 1956-08-13 1996-05-14 - 1997-06-30 INACTIVE

Office Location

Street Address 69 GATE RIDGE RD
City FAIRFIELD
State CT
Zip Code 06432-1170

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Competitor

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City FAIRFIELD
Zip Code 06432
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FAIRFIELD

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Herman K Dolin 15 Columbus Ave, Niantic, CT 06357 Controlled Substance Registration for Practitioner 1993-06-02 ~ 1995-06-01
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Herman D Marggraff Jr 386 Straits Turnpike, Watertown, CT 06795-3124 Controlled Substance Registration for Practitioner 1993-12-07 ~ 1996-01-01
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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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