PRACHA P EAMRANOND
Controlled Substance Registration for Practitioner


Address: 5 Phinney Rd, Lexington, MA 02421-7716

PRACHA P EAMRANOND (Credential# 1623381) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is January 2, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.

Business Overview

PRACHA P EAMRANOND is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0070042. The credential type is controlled substance registration for practitioner. The effective date is January 2, 2019. The expiration date is February 28, 2021. The business address is 5 Phinney Rd, Lexington, MA 02421-7716. The current status is active.

Basic Information

Licensee Name PRACHA P EAMRANOND
Credential ID 1623381
Credential Number CSP.0070042
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 5 Phinney Rd
Lexington
MA 02421-7716
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2019-01-02
Effective Date 2019-01-02
Expiration Date 2021-02-28
Refresh Date 2019-01-03

Other licenses

ID Credential Code Credential Type Issue Term Status
559886 1.042304 Physician/Surgeon 2004-04-08 2019-11-01 - 2020-10-31 ACTIVE
368525 CSP.0034845 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2004-06-21 2004-06-21 - 2005-02-28 INACTIVE

Office Location

Street Address 5 PHINNEY RD
City LEXINGTON
State MA
Zip Code 02421-7716

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Competitor

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City LEXINGTON
Zip Code 02421
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + LEXINGTON

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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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