VIVIAN C SHIH
Controlled Substance Registration for Practitioner


Address: 36 Judd Hill Rd, Bethany, CT 06524-3094

VIVIAN C SHIH (Credential# 386456) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.

Business Overview

VIVIAN C SHIH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0036586. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 36 Judd Hill Rd, Bethany, CT 06524-3094. The current status is lapsed.

Basic Information

Licensee Name VIVIAN C SHIH
Credential ID 386456
Credential Number CSP.0036586
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 36 Judd Hill Rd
Bethany
CT 06524-3094
Business Type INDIVIDUAL
Status LAPSED
Active 1
Issue Date 2004-11-09
Effective Date 2017-03-01
Expiration Date 2019-02-28
Refresh Date 2019-03-06

Other licenses

ID Credential Code Credential Type Issue Term Status
560481 1.042899 Physician/Surgeon 2004-10-26 2018-01-01 - 2018-12-31 INACTIVE
386455 PCI.0005412 PHARMACY INTERN - EXPIRED APPLICATION

Office Location

Street Address 36 JUDD HILL RD
City BETHANY
State CT
Zip Code 06524-3094

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Competitor

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City BETHANY
Zip Code 06524
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BETHANY

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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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