SUSANNA VAYSTUB OD
Controlled Substance Registration for Practitioner


Address: 4701 Fieldston Rd, Riverdale, NY 10471

SUSANNA VAYSTUB OD (Credential# 399261) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.

Business Overview

SUSANNA VAYSTUB OD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0037167. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2013. The expiration date is February 28, 2015. The business address is 4701 Fieldston Rd, Riverdale, NY 10471. The current status is inactive.

Basic Information

Licensee Name SUSANNA VAYSTUB OD
Credential ID 399261
Credential Number CSP.0037167
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 4701 Fieldston Rd
Riverdale
NY 10471
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2005-04-08
Effective Date 2013-03-01
Expiration Date 2015-02-28
Refresh Date 2016-01-29

Office Location

Street Address 4701 Fieldston Rd
City RIVERDALE
State NY
Zip Code 10471

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Competitor

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City RIVERDALE
Zip Code 10471
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + RIVERDALE

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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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