ELECTRA V KALOUDIS
Controlled Substance Registration for Practitioner


Address: 24 Fernwood Rd, West Hartford, CT 06119-1163

ELECTRA V KALOUDIS (Credential# 935001) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.

Business Overview

ELECTRA V KALOUDIS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0047760. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 24 Fernwood Rd, West Hartford, CT 06119-1163. The current status is active.

Basic Information

Licensee Name ELECTRA V KALOUDIS
Credential ID 935001
Credential Number CSP.0047760
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 24 Fernwood Rd
West Hartford
CT 06119-1163
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2010-06-15
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2019-01-25

Other licenses

ID Credential Code Credential Type Issue Term Status
921090 1.048681 Physician/Surgeon 2010-04-27 2019-08-01 - 2020-07-31 ACTIVE

Office Location

Street Address 24 FERNWOOD RD
City WEST HARTFORD
State CT
Zip Code 06119-1163

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Anne London Tcherepnin 46 Fernwood Rd, West Hartford, CT 06119-1163 Dietitian/nutritionist 2013-02-01 ~ 2014-02-28
Talbot Fucci 16 Fernwood Rd, West Hartford, CT 06119-1163 Wholesaler Salesman 2001-07-03 ~ 2013-01-31

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Competitor

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City WEST HARTFORD
Zip Code 06119
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WEST HARTFORD

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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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