GLORIA A DIAZ
Controlled Substance Registration for Practitioner


Address: 3337 71st St, Jackson Heights, NY 11372-1050

GLORIA A DIAZ (Credential# 535578) 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, 2017. The license status is INACTIVE.

Business Overview

GLORIA A DIAZ is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0045659. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2013. The expiration date is February 28, 2017. The business address is 3337 71st St, Jackson Heights, NY 11372-1050. The current status is inactive.

Basic Information

Licensee Name GLORIA A DIAZ
Credential ID 535578
Credential Number CSP.0045659
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 3337 71st St
Jackson Heights
NY 11372-1050
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2009-06-22
Effective Date 2013-03-01
Expiration Date 2017-02-28
Refresh Date 2018-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
703167 2.008715 Dentist 2000-02-23 2016-02-24 - 2016-04-30 INACTIVE

Office Location

Street Address 3337 71ST ST
City JACKSON HEIGHTS
State NY
Zip Code 11372-1050

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Competitor

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City JACKSON HEIGHTS
Zip Code 11372
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + JACKSON 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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