NICOLE L SUSSER DO
Controlled Substance Registration for Practitioner


Address: 8 Dellworth Drive, Yorktown Heights, NY 10598

NICOLE L SUSSER DO (Credential# 331963) 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

NICOLE L SUSSER DO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0033216. 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 8 Dellworth Drive, Yorktown Heights, NY 10598. The current status is inactive.

Basic Information

Licensee Name NICOLE L SUSSER DO
Credential ID 331963
Credential Number CSP.0033216
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 8 Dellworth Drive
Yorktown Heights
NY 10598
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
558679 1.041096-DO Physician/Surgeon 2003-01-28 2003-03-13 - 2004-04-30 INACTIVE

Office Location

Street Address 8 DELLWORTH DRIVE
City YORKTOWN HEIGHTS
State NY
Zip Code 10598

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Roger J Lewis Md 8 Dellworth Drive, Yorktown Heights, NY 10598 Controlled Substance Registration for Practitioner 2004-02-29 ~ 2005-02-28

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Competitor

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City YORKTOWN HEIGHTS
Zip Code 10598
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + YORKTOWN HEIGHTS

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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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