SHIVA HEJAZI-PRUETT
Controlled Substance Registration for Practitioner


Address: 196 Crown St #504, New Haven, CT 06510

SHIVA HEJAZI-PRUETT (Credential# 380163) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2006. The license expiration date date is February 28, 2007. The license status is INACTIVE.

Business Overview

SHIVA HEJAZI-PRUETT is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0035902. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2006. The expiration date is February 28, 2007. The business address is 196 Crown St #504, New Haven, CT 06510. The current status is inactive.

Basic Information

Licensee Name SHIVA HEJAZI-PRUETT
Credential ID 380163
Credential Number CSP.0035902
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 196 Crown St #504
New Haven
CT 06510
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2004-09-03
Effective Date 2006-03-01
Expiration Date 2007-02-28
Refresh Date 2009-01-26

Office Location

Street Address 196 CROWN ST #504
City NEW HAVEN
State CT
Zip Code 06510

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Competitor

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City NEW HAVEN
Zip Code 06510
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW HAVEN

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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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