TAMIKA J LOTT MD
Controlled Substance Registration for Practitioner


Address: 979 Glenwood Ave. Se, Atlanta, GA 30316

TAMIKA J LOTT MD (Credential# 990117) 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

TAMIKA J LOTT MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0049839. 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 979 Glenwood Ave. Se, Atlanta, GA 30316. The current status is lapsed.

Basic Information

Licensee Name TAMIKA J LOTT MD
Credential ID 990117
Credential Number CSP.0049839
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 979 Glenwood Ave. Se
Atlanta
GA 30316
Business Type INDIVIDUAL
Status LAPSED
Active 1
Issue Date 2011-03-30
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
948902 1.049289 Physician/Surgeon 2010-10-21 2016-07-01 - 2017-06-30 INACTIVE

Office Location

Street Address 979 Glenwood Ave. SE
City Atlanta
State GA
Zip Code 30316

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Anna Kristine Roth 486 Haas Ave Se, Atlanta, GA 30316-1651 Registered Nurse 2019-12-04 ~ 2020-10-31
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Competitor

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City Atlanta
Zip Code 30316
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Atlanta

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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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