ELVIS R RODRIGUEZ
Physician/surgeon


Address: 54 Roser Dr, Glastonbury, CT 06033-2329

ELVIS R RODRIGUEZ (Credential# 1203261) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.

Business Overview

ELVIS R RODRIGUEZ is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.052831. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 54 Roser Dr, Glastonbury, CT 06033-2329. The current status is active.

Basic Information

Licensee Name ELVIS R RODRIGUEZ
Credential ID 1203261
Credential Number 1.052831
Credential Type Physician/Surgeon
Business Address 54 Roser Dr
Glastonbury
CT 06033-2329
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2014-03-13
Effective Date 2020-04-01
Expiration Date 2021-03-31
Refresh Date 2020-03-04

Other licenses

ID Credential Code Credential Type Issue Term Status
2018479 CSP.0073394 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2020-03-19 2020-03-19 - 2021-02-28 ACTIVE
1409649 CSP.0064938 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2017-03-02 2019-03-01 - 2021-02-28 ACTIVE
1211981 CSP.0056848 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2014-04-01 2015-03-01 - 2017-02-28 INACTIVE

Office Location

Street Address 54 ROSER DR
City GLASTONBURY
State CT
Zip Code 06033-2329

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Competitor

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City GLASTONBURY
Zip Code 06033
License Type Physician/Surgeon
License Type + County Physician/Surgeon + GLASTONBURY

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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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