WILLEATHA TAYLOR
Controlled Substance Registration for Practitioner


Address: 179 Brookdale Ave, New Rochelle, NY 10801

WILLEATHA TAYLOR (Credential# 1248191) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.

Business Overview

WILLEATHA TAYLOR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0058806. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 179 Brookdale Ave, New Rochelle, NY 10801. The current status is active.

Basic Information

Licensee Name WILLEATHA TAYLOR
Credential ID 1248191
Credential Number CSP.0058806
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 179 Brookdale Ave
New Rochelle
NY 10801
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2014-11-19
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2019-02-26

Other licenses

ID Credential Code Credential Type Issue Term Status
1248649 1.053675 Physician/Surgeon 2014-11-18 2019-08-01 - 2020-07-31 ACTIVE

Office Location

Street Address 179 Brookdale Ave
City New Rochelle
State NY
Zip Code 10801

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Competitor

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City New Rochelle
Zip Code 10801
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + New Rochelle

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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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