GOTTFRIED VON KEUDELL
Controlled Substance Registration for Practitioner


Address: 671 Orange St Apt 9, New Haven, CT 06511-2571

GOTTFRIED VON KEUDELL (Credential# 1307397) 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

GOTTFRIED VON KEUDELL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0061382. 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 671 Orange St Apt 9, New Haven, CT 06511-2571. The current status is lapsed.

Basic Information

Licensee Name GOTTFRIED VON KEUDELL
Credential ID 1307397
Credential Number CSP.0061382
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 671 Orange St Apt 9
New Haven
CT 06511-2571
Business Type INDIVIDUAL
Status LAPSED
Active 1
Issue Date 2015-09-16
Effective Date 2017-03-01
Expiration Date 2019-02-28
Refresh Date 2019-03-06

Other licenses

ID Credential Code Credential Type Issue Term Status
1280500 1.054615 Physician/Surgeon 2015-09-15 2017-07-01 - 2018-06-30 INACTIVE
1305319 1 Physician/Surgeon - PENDING

Office Location

Street Address 671 ORANGE ST APT 9
City NEW HAVEN
State CT
Zip Code 06511-2571

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Frank J Pannenborg 505 Ellsworth Ave, New Haven, CT 06511 Architect 2020-08-01 ~ 2021-07-31
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Competitor

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City NEW HAVEN
Zip Code 06511
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW HAVEN

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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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