KRYSTIAN KOZAK
Controlled Substance Registration for Practitioner


Address: 290 Main St Unit 211, Bridgeport, CT 06604-5520

KRYSTIAN KOZAK (Credential# 1297885) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.

Business Overview

KRYSTIAN KOZAK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0060880. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 290 Main St Unit 211, Bridgeport, CT 06604-5520. The current status is lapsed.

Basic Information

Licensee Name KRYSTIAN KOZAK
Credential ID 1297885
Credential Number CSP.0060880
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 290 Main St Unit 211
Bridgeport
CT 06604-5520
Business Type INDIVIDUAL
Status LAPSED
Active 1
Issue Date 2015-07-07
Effective Date 2017-03-01
Expiration Date 2019-02-28
Refresh Date 2019-03-06

Office Location

Street Address 290 MAIN ST UNIT 211
City BRIDGEPORT
State CT
Zip Code 06604-5520

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Competitor

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City BRIDGEPORT
Zip Code 06604
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRIDGEPORT

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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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