IOANNIS STATHOPOULOS MD
Controlled Substance Registration for Practitioner


Address: 2 Bostwick Ln, Old Westbury, NY 11568-1602

IOANNIS STATHOPOULOS MD (Credential# 991631) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is April 8, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.

Business Overview

IOANNIS STATHOPOULOS MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0049895. The credential type is controlled substance registration for practitioner. The effective date is April 8, 2011. The expiration date is February 28, 2013. The business address is 2 Bostwick Ln, Old Westbury, NY 11568-1602. The current status is inactive.

Basic Information

Licensee Name IOANNIS STATHOPOULOS MD
Credential ID 991631
Credential Number CSP.0049895
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 2 Bostwick Ln
Old Westbury
NY 11568-1602
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2011-04-08
Effective Date 2011-04-08
Expiration Date 2013-02-28
Refresh Date 2014-07-24

Other licenses

ID Credential Code Credential Type Issue Term Status
937610 1.049483 Physician/Surgeon 2011-02-04 2011-10-01 - 2012-09-30 INACTIVE

Office Location

Street Address 2 BOSTWICK LN
City OLD WESTBURY
State NY
Zip Code 11568-1602

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City OLD WESTBURY
Zip Code 11568
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + OLD WESTBURY

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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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