ELISE J CONNELL-BOUDOYA
Controlled Substance Registration for Practitioner


Address: 102 Moody St, Bristol, CT 06010

ELISE J CONNELL-BOUDOYA (Credential# 498581) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2009. The license expiration date date is February 28, 2011. The license status is INACTIVE.

Business Overview

ELISE J CONNELL-BOUDOYA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0043305. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2009. The expiration date is February 28, 2011. The business address is 102 Moody St, Bristol, CT 06010. The current status is inactive.

Basic Information

Licensee Name ELISE J CONNELL-BOUDOYA
Credential ID 498581
Credential Number CSP.0043305
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 102 Moody St
Bristol
CT 06010
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2008-04-01
Effective Date 2009-03-01
Expiration Date 2011-02-28
Refresh Date 2013-03-07

Other licenses

ID Credential Code Credential Type Issue Term Status
562089 1.044507 Physician/Surgeon 2006-06-26 2008-05-29 - 2009-06-30 INACTIVE

Office Location

Street Address 102 MOODY ST
City BRISTOL
State CT
Zip Code 06010

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Competitor

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City BRISTOL
Zip Code 06010
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRISTOL

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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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