ANNA GOMBERG MD
Controlled Substance Registration for Practitioner


Address: 503 Pleasantville Rd, Briarcliff, NY 10510

ANNA GOMBERG MD (Credential# 207246) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is April 19, 2004. The license expiration date date is February 28, 2005. The license status is INACTIVE.

Business Overview

ANNA GOMBERG MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0027795. The credential type is controlled substance registration for practitioner. The effective date is April 19, 2004. The expiration date is February 28, 2005. The business address is 503 Pleasantville Rd, Briarcliff, NY 10510. The current status is inactive.

Basic Information

Licensee Name ANNA GOMBERG MD
Credential ID 207246
Credential Number CSP.0027795
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 503 Pleasantville Rd
Briarcliff
NY 10510
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2004-04-19
Expiration Date 2005-02-28
Refresh Date 2009-01-26

Other licenses

ID Credential Code Credential Type Issue Term Status
554868 1.037278 Physician/Surgeon 1998-10-02 2004-04-19 - 2005-01-31 INACTIVE

Office Location

Street Address 503 PLEASANTVILLE RD
City BRIARCLIFF
State NY
Zip Code 10510

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Competitor

Search similar business entities

City BRIARCLIFF
Zip Code 10510
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRIARCLIFF

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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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