CATHY L SHEREDOS-FUNFGELD PA
Controlled Substance Registration for Practitioner


Address: 216 Gardner Ave, Jericho, NY 11753

CATHY L SHEREDOS-FUNFGELD PA (Credential# 462429) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.

Business Overview

CATHY L SHEREDOS-FUNFGELD PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0041094. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2011. The expiration date is February 28, 2013. The business address is 216 Gardner Ave, Jericho, NY 11753. The current status is inactive.

Basic Information

Licensee Name CATHY L SHEREDOS-FUNFGELD PA
Credential ID 462429
Credential Number CSP.0041094
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 216 Gardner Ave
Jericho
NY 11753
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2007-02-07
Effective Date 2011-03-01
Expiration Date 2013-02-28
Refresh Date 2014-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
743626 23.001877 Physician Assistant 2007-01-19 2010-08-01 - 2011-07-31 INACTIVE

Office Location

Street Address 216 GARDNER AVE
City JERICHO
State NY
Zip Code 11753

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Competitor

Search similar business entities

City JERICHO
Zip Code 11753
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + JERICHO

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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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