GUSTAVO REYNOSO
Physician/surgeon


Address: 18 Charter Oak Drive, Oxford, CT 06478

GUSTAVO REYNOSO (Credential# 544642) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 18, 2003. The license expiration date date is September 30, 2004. The license status is INACTIVE.

Business Overview

GUSTAVO REYNOSO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.023612. The credential type is physician/surgeon. The effective date is August 18, 2003. The expiration date is September 30, 2004. The business address is 18 Charter Oak Drive, Oxford, CT 06478. The current status is inactive.

Basic Information

Licensee Name GUSTAVO REYNOSO
Credential ID 544642
Credential Number 1.023612
Credential Type Physician/Surgeon
Business Address 18 Charter Oak Drive
Oxford
CT 06478
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1982-06-10
Effective Date 2003-08-18
Expiration Date 2004-09-30
Refresh Date 2009-07-08

Other licenses

ID Credential Code Credential Type Issue Term Status
158721 CSP.0018053 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 1994-03-16 - 1996-04-01 INACTIVE
153278 CSP.0011847 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 1995-03-20 - 1996-02-28 INACTIVE

Office Location

Street Address 18 CHARTER OAK DRIVE
City Oxford
State CT
Zip Code 06478

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Anna B Valko 6 Jem Woods Road, Oxford, CT 06478 Notary Public Appointment 2020-09-01 ~ 2025-08-31
Southbury Baking Company LLC 83 Prokop Road, Oxford, CT 06478 Bakery 2020-07-01 ~ 2021-06-30
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Andy Petitti 5 Benson Road, Oxford, CT 06478 Cross Connection Survey Inspector 2020-04-01 ~ 2023-03-31
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Competitor

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City Oxford
Zip Code 06478
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Oxford

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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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