VLADIMIR ILIC MD
Controlled Substance Registration for Practitioner


Address: 625 Main Street, New York, NY 10044

VLADIMIR ILIC MD (Credential# 210783) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is February 29, 2004. The license expiration date date is February 28, 2005. The license status is INACTIVE.

Business Overview

VLADIMIR ILIC MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0028092. The credential type is controlled substance registration for practitioner. The effective date is February 29, 2004. The expiration date is February 28, 2005. The business address is 625 Main Street, New York, NY 10044. The current status is inactive.

Basic Information

Licensee Name VLADIMIR ILIC MD
Credential ID 210783
Credential Number CSP.0028092
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 625 Main Street
New York
NY 10044
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2004-02-29
Expiration Date 2005-02-28
Refresh Date 2009-01-26

Other licenses

ID Credential Code Credential Type Issue Term Status
555145 1.037555 Physician/Surgeon 1999-03-05 2004-01-14 - 2005-01-31 INACTIVE

Office Location

Street Address 625 MAIN STREET
City NEW YORK
State NY
Zip Code 10044

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City NEW YORK
Zip Code 10044
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW YORK

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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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