MICAL O RAZ
Controlled Substance Registration for Practitioner


Address: 4300 Spruce St Apt A100, Philadelphia, PA 19104-4759

MICAL O RAZ (Credential# 1171477) 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

MICAL O RAZ is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0055184. 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 4300 Spruce St Apt A100, Philadelphia, PA 19104-4759. The current status is inactive.

Basic Information

Licensee Name MICAL O RAZ
Credential ID 1171477
Credential Number CSP.0055184
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 4300 Spruce St Apt A100
Philadelphia
PA 19104-4759
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2013-07-01
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
1284212 1.054573 Physician/Surgeon 2015-08-27 2015-12-01 - 2016-11-30 INACTIVE

Office Location

Street Address 4300 SPRUCE ST APT A100
City PHILADELPHIA
State PA
Zip Code 19104-4759

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Competitor

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City PHILADELPHIA
Zip Code 19104
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PHILADELPHIA

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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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