JERRY CRAWFORD
Controlled Substance Registration for Practitioner


Address: 33 Foothills Way, Bloomfield, CT 06002-0896

JERRY CRAWFORD (Credential# 157075) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2001. The license expiration date date is February 28, 2002. The license status is INACTIVE.

Business Overview

JERRY CRAWFORD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0015723. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2001. The expiration date is February 28, 2002. The business address is 33 Foothills Way, Bloomfield, CT 06002-0896. The current status is inactive.

Basic Information

Licensee Name JERRY CRAWFORD
Credential ID 157075
Credential Number CSP.0015723
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 33 Foothills Way
Bloomfield
CT 06002-0896
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2001-03-01
Expiration Date 2002-02-28
Refresh Date 2009-01-26

Other licenses

ID Credential Code Credential Type Issue Term Status
539879 1.011063 Physician/Surgeon 1962-08-21 2000-11-20 - 2002-01-31 INACTIVE

Office Location

Street Address 33 FOOTHILLS WAY
City BLOOMFIELD
State CT
Zip Code 06002-0896

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Competitor

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City BLOOMFIELD
Zip Code 06002
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BLOOMFIELD

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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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