KENNETH M FOMBERSTEIN (Credential# 942661) 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.
KENNETH M FOMBERSTEIN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0047906. 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 401 E 80st 17b, New York, NY 10075. The current status is active.
| Licensee Name | KENNETH M FOMBERSTEIN |
| Credential ID | 942661 |
| Credential Number | CSP.0047906 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
401 E 80st 17b New York NY 10075 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2010-07-12 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-22 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1211436 | 1.052958 | Physician/Surgeon | 2014-04-29 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 401 E 80ST 17B |
| City | NEW YORK |
| State | NY |
| Zip Code | 10075 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| I Rand Rodgers Md | 229 East 79th St, New York City, NY 10075 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Li C Pei | 151 East 79th St, New York, NY 10075 | Architect | 2020-05-07 ~ 2020-07-31 |
| Laure C Aubuchon | 325 East 79th Street, New York, NY 10075 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Alexandra Zavin | 539 E 78th St #6i, New York, NY 10075 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Timothy Godaire | 509 E 77th Street Apt 6m, New York, NY 10075 | Home Improvement Salesperson | 2020-03-09 ~ 2020-11-30 |
| Emil K Heringer | 511 East 80th St, New York, NY 10075 | Optometrist | 2020-01-01 ~ 2020-12-31 |
| Norman Maurice Rowe | 71 East 77th Street, Suite 1a, New York, NY 10075 | Physician/surgeon | 2020-02-29 ~ 2021-02-28 |
| Wendee K Schildhaus | 124 East 79th Street, New York, NY 10075 | Marital and Family Therapist | 2020-04-01 ~ 2021-03-31 |
| Chien C Pei | 225 East 79th St, New York, NY 10075 | Architect | 2020-01-28 ~ 2018-07-31 |
| David R Ortiz | 445 East 77th Street, New York, NY 10075 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Find all Licenses in zip 10075 | |||
| City | NEW YORK |
| Zip Code | 10075 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW YORK |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kenneth O. Bonaparte | Groton, CT 06340 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Kenneth M Gheen Md | 809 Noe Rd, Larkspur, CO 80118 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Kenneth J Eagan Dds | 146 Elm St, Cheshire, CT 06410 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Kenneth Powers Md | 50 Orchard Ave, Rye, NY 10580-2806 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Kenneth J Lippman Md | 18 Sylvan Rd S, Westport, CT 06880 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kenneth H Schulte | 201 Canal Rd, Suffield, CT 06078 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Kenneth Wachs Dds | 36 Padanaram Rd, Danbury, CT 06811 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kenneth J Garcia | 460 W 236th St Apt W-3a, Bronx, NY 10463-2073 | Controlled Substance Registration for Practitioner | 2019-03-07 ~ 2021-02-28 |
| Kenneth W Hung | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-03-25 ~ 2021-02-28 |
| Kenneth M Forte | 52 Wilson St, Milford, CT 06461-2538 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on KENNETH M FOMBERSTEIN.
| 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).