FAFA K XEXEMEKU
Controlled Substance Registration for Practitioner


Address: 185 Canal St Unit 3094, Shelton, CT 06484

FAFA K XEXEMEKU (Credential# 944084) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.

Business Overview

FAFA K XEXEMEKU is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0048063. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2015. The expiration date is February 28, 2017. The business address is 185 Canal St Unit 3094, Shelton, CT 06484. The current status is inactive.

Basic Information

Licensee Name FAFA K XEXEMEKU
Credential ID 944084
Credential Number CSP.0048063
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 185 Canal St Unit 3094
Shelton
CT 06484
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2010-07-27
Effective Date 2015-03-01
Expiration Date 2017-02-28
Refresh Date 2018-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
1036630 1.050407 Physician/Surgeon 2011-10-27 2015-05-01 - 2016-04-30 INACTIVE

Office Location

Street Address 185 CANAL ST UNIT 3094
City SHELTON
State CT
Zip Code 06484

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Competitor

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City SHELTON
Zip Code 06484
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SHELTON

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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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