MICHAEL BOTHWELL PA (Credential# 193163) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.
MICHAEL BOTHWELL PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0026784. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2015. The expiration date is February 28, 2017. The business address is 27 Foothill Road, Bronxville, NY 10708. The current status is inactive.
| Licensee Name | MICHAEL BOTHWELL PA |
| Credential ID | 193163 |
| Credential Number | CSP.0026784 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
27 Foothill Road Bronxville NY 10708 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 2015-03-01 |
| Expiration Date | 2017-02-28 |
| Refresh Date | 2018-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 742469 | 23.000720 | Physician Assistant | 1998-02-06 | 2012-11-01 - 2013-10-31 | INACTIVE |
| Street Address | 27 Foothill Road |
| City | Bronxville |
| State | NY |
| Zip Code | 10708 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Carmelita Reyes-montinola | 801 Bronx River Rd, Bronxville, NY 10708 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Hedieh Honarpisheh | 52 Howe Place, Bronxville, NY 10708 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Joshua Brandfonbrener | 9 Alden Place, Bronxville, NY 10708 | Architect | 2020-08-01 ~ 2021-07-31 |
| Ayako Takahata | 76a Oregon Ave, Bronxville, NY 10708 | Real Estate Salesperson | 2017-06-01 ~ 2018-05-31 |
| Anne H Angevine Md | 14 Westway, Bronxville, NY 10708 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Stephen Ryan Meyers | 4 Valley Road, Bronxville, NY 10708 | Real Estate Broker | 2019-04-01 ~ 2020-03-31 |
| Caroline S Beit | 11 White Plains Road, Bronxville, NY 10708 | Emergency Medical Technician | ~ |
| Philip J Overby Md | 133 Pondfield Road, Bronxville, NY 10708 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Anna Belman | 55 Palmer Avenue, Bronxville, NY 10708 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Michele L Rohr Md | 43 Greenfield Ave, Bronxville, NY 10708 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 10708 | |||
| City | Bronxville |
| Zip Code | 10708 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Bronxville |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Stacey C Michael Dmd | Michael Dental of Clinton, LLC, Clilnton, CT 06413 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Alfred Bothwell · Yale University School of Medicine | 1 Gilbert St, New Haven, CT 06519-1621 | Controlled Substance Laboratory | 2020-02-01 ~ 2021-01-31 |
| Michael K Hwang Dmd | Michael K Hwang, Dmd, LLC, East Hartford, CT 06108 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael Blefeld | 495 Rt 184, Groton, CT 06340 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael Lao | 195 Hartford Rd Apt C32, New Britain, CT 06053-1519 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Michael M Talty Pa | Wingdale, NY 12594 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Michael Reisman Dds | 128 Lee Dr, Southington, CT 06489 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael M Caruso | Po Box 988, Torrington, CT 06790 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael D Stangler | Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael Ring Md | Hartford, CT 06105 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
Please comment or provide details below to improve the information on MICHAEL BOTHWELL PA.
| 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).