ELCHANAN BRUCKHEIMER MD
Controlled Substance Registration for Practitioner


Address: 432 Ellsworth Ave, New Haven, CT 06511

ELCHANAN BRUCKHEIMER MD (Credential# 175619) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 1997. The license expiration date date is February 28, 1998. The license status is INACTIVE.

Business Overview

ELCHANAN BRUCKHEIMER MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0024616. The credential type is controlled substance registration for practitioner. The effective date is March 1, 1997. The expiration date is February 28, 1998. The business address is 432 Ellsworth Ave, New Haven, CT 06511. The current status is inactive.

Basic Information

Licensee Name ELCHANAN BRUCKHEIMER MD
Credential ID 175619
Credential Number CSP.0024616
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 432 Ellsworth Ave
New Haven
CT 06511
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 1997-03-01
Expiration Date 1998-02-28
Refresh Date 2005-12-15

Office Location

Street Address 432 ELLSWORTH AVE
City NEW HAVEN
State CT
Zip Code 06511

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Cary M Tucker 64 Bishop St, New Haven, CT 06511 Architect 2020-08-01 ~ 2021-07-31
Frank J Pannenborg 505 Ellsworth Ave, New Haven, CT 06511 Architect 2020-08-01 ~ 2021-07-31
Crystal E Gooding 26 Woodland Street, New Haven, CT 06511 Notary Public Appointment 2020-07-01 ~ 2025-06-30
Kieran Jones 260 Crown St Unit 1f, New Haven, CT 06511 Registered Nurse ~
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Competitor

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City NEW HAVEN
Zip Code 06511
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW HAVEN

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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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