DANIEL M EPELBAUM
Controlled Substance Registration for Practitioner


Address: 12 Lake Shore Ave, Derry, NH 03038-5100

DANIEL M EPELBAUM (Credential# 928787) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.

Business Overview

DANIEL M EPELBAUM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0047631. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 12 Lake Shore Ave, Derry, NH 03038-5100. The current status is lapsed.

Basic Information

Licensee Name DANIEL M EPELBAUM
Credential ID 928787
Credential Number CSP.0047631
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 12 Lake Shore Ave
Derry
NH 03038-5100
Business Type INDIVIDUAL
Status LAPSED
Active 1
Issue Date 2010-05-17
Effective Date 2017-03-01
Expiration Date 2019-02-28
Refresh Date 2019-03-06

Other licenses

ID Credential Code Credential Type Issue Term Status
918321 1.048568 Physician/Surgeon 2010-03-25 2017-06-01 - 2018-05-31 INACTIVE

Office Location

Street Address 12 LAKE SHORE AVE
City DERRY
State NH
Zip Code 03038-5100

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Competitor

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City DERRY
Zip Code 03038
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + DERRY

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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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