YELENA POTYLITSINA MD
Controlled Substance Registration for Practitioner


Address: 45 Coolidge Ave, Roslyn Heights, NY 11577

YELENA POTYLITSINA MD (Credential# 458037) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is February 7, 2007. The license expiration date date is February 28, 2008. The license status is INACTIVE.

Business Overview

YELENA POTYLITSINA MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0040951. The credential type is controlled substance registration for practitioner. The effective date is February 7, 2007. The expiration date is February 28, 2008. The business address is 45 Coolidge Ave, Roslyn Heights, NY 11577. The current status is inactive.

Basic Information

Licensee Name YELENA POTYLITSINA MD
Credential ID 458037
Credential Number CSP.0040951
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 45 Coolidge Ave
Roslyn Heights
NY 11577
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2007-02-07
Effective Date 2007-02-07
Expiration Date 2008-02-28
Refresh Date 2009-02-05

Other licenses

ID Credential Code Credential Type Issue Term Status
562577 1.044995 Physician/Surgeon 2006-12-21 2006-12-21 - 2007-10-31 INACTIVE

Office Location

Street Address 45 COOLIDGE AVE
City ROSLYN HEIGHTS
State NY
Zip Code 11577

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Competitor

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City ROSLYN HEIGHTS
Zip Code 11577
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + ROSLYN HEIGHTS

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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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