ELSA RUSSOM CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER

Address: 3 Marvin Street, Norwalk, CT 06855

ELSA RUSSOM (Credential# 1186765) is CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER licensed with Connecticut Department of Consumer Protection. The license expiration date is 2017-02-28.

Business Overview

Name ELSA RUSSOM
Credential ID 1186765
Credential Code CSP.0056192
Credential CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Address 3 Marvin Street
Norwalk
CT 06855
Type INDIVIDUAL
Status LAPSED
Active 1
Issue Date 2013-09-26
Effective Date 2015-03-01
Expiration Date 2017-02-28
Refresh Date 2017-05-02

Other licenses

ID Credential Code Credential Type Term Status
1178458 1.052443 Physician/Surgeon 2015-01-01 - 2015-12-31 INACTIVE

Office Location

Street Address 3 Marvin Street
City Norwalk
State CT
Zip Code 06855

Entities with the same location

Name Office Address Expiration Date
ELSA RUSSOM 3 Marvin Street, Norwalk, CT 06855 2015-12-31

Competitor

Search similar business entities

City Norwalk
Zip Code 06855
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Norwalk

Improve Information

Please comment or provide details below to improve the information on .

Dataset Information

Data Provider Connecticut Department of Consumer Protection
Jurisdiction Connecticut

This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).