DILRUBA KHANAM MD
Controlled Substance Registration for Practitioner


Address: 121 Exeter Court, Piscataway, NJ 08854

DILRUBA KHANAM MD (Credential# 406254) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is June 6, 2005. The license expiration date date is February 28, 2006. The license status is INACTIVE.

Business Overview

DILRUBA KHANAM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0037548. The credential type is controlled substance registration for practitioner. The effective date is June 6, 2005. The expiration date is February 28, 2006. The business address is 121 Exeter Court, Piscataway, NJ 08854. The current status is inactive.

Basic Information

Licensee Name DILRUBA KHANAM MD
Credential ID 406254
Credential Number CSP.0037548
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 121 Exeter Court
Piscataway
NJ 08854
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2005-06-06
Effective Date 2005-06-06
Expiration Date 2006-02-28
Refresh Date 2009-01-26

Other licenses

ID Credential Code Credential Type Issue Term Status
560590 1.043008 Physician/Surgeon 2004-12-22 2004-12-22 - 2005-11-30 INACTIVE

Office Location

Street Address 121 EXETER COURT
City PISCATAWAY
State NJ
Zip Code 08854

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Competitor

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City PISCATAWAY
Zip Code 08854
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PISCATAWAY

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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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