JONATHAN D BLANCAFLOR
Controlled Substance Registration for Practitioner


Address: 1656 Champlin Ave Ste 222, Utica, NY 13502-4830

JONATHAN D BLANCAFLOR (Credential# 158798) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.

Business Overview

JONATHAN D BLANCAFLOR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0019077. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 1656 Champlin Ave Ste 222, Utica, NY 13502-4830. The current status is active.

Basic Information

Licensee Name JONATHAN D BLANCAFLOR
Credential ID 158798
Credential Number CSP.0019077
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 1656 Champlin Ave Ste 222
Utica
NY 13502-4830
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 1999-03-01
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2019-01-25

Other licenses

ID Credential Code Credential Type Issue Term Status
548716 1.030814 Physician/Surgeon 1990-06-01 2019-11-01 - 2020-10-31 ACTIVE

Office Location

Street Address 1656 CHAMPLIN AVE STE 222
City UTICA
State NY
Zip Code 13502-4830

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Competitor

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City UTICA
Zip Code 13502
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + UTICA

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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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