MARSHA Y RUSSELL MD
Controlled Substance Registration for Practitioner


Address: 20 Leslie Rd, Bridgeport, CT 06606

MARSHA Y RUSSELL MD (Credential# 382521) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is October 20, 2004. The license expiration date date is February 28, 2005. The license status is INACTIVE.

Business Overview

MARSHA Y RUSSELL MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0036444. The credential type is controlled substance registration for practitioner. The effective date is October 20, 2004. The expiration date is February 28, 2005. The business address is 20 Leslie Rd, Bridgeport, CT 06606. The current status is inactive.

Basic Information

Licensee Name MARSHA Y RUSSELL MD
Credential ID 382521
Credential Number CSP.0036444
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 20 Leslie Rd
Bridgeport
CT 06606
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2004-10-20
Effective Date 2004-10-20
Expiration Date 2005-02-28
Refresh Date 2009-01-26

Office Location

Street Address 20 LESLIE RD
City BRIDGEPORT
State CT
Zip Code 06606

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Teresa Ferrara 20 Leslie Rd, Bridgeport, CT 06606 Hairdresser/cosmetician 1998-07-15 ~ 1999-08-31

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Competitor

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City BRIDGEPORT
Zip Code 06606
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRIDGEPORT

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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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