MARYAM EDALAT DDS
Controlled Substance Registration for Practitioner


Address: 420 Easr 58th Street, New York City, NY 10022

MARYAM EDALAT DDS (Credential# 221303) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is February 29, 2000. The license expiration date date is February 28, 2001. The license status is INACTIVE.

Business Overview

MARYAM EDALAT DDS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0028876. The credential type is controlled substance registration for practitioner. The effective date is February 29, 2000. The expiration date is February 28, 2001. The business address is 420 Easr 58th Street, New York City, NY 10022. The current status is inactive.

Basic Information

Licensee Name MARYAM EDALAT DDS
Credential ID 221303
Credential Number CSP.0028876
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 420 Easr 58th Street
New York City
NY 10022
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2000-02-29
Expiration Date 2001-02-28
Refresh Date 2009-01-26

Other licenses

ID Credential Code Credential Type Issue Term Status
703118 2.008666 Dentist 1999-09-07 1999-09-07 - 2000-02-29 INACTIVE

Office Location

Street Address 420 EASR 58TH STREET
City NEW YORK CITY
State NY
Zip Code 10022

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Competitor

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City NEW YORK CITY
Zip Code 10022
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW YORK CITY

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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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