KETEVAN N GVALIA (Credential# 1430874) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license status is INACTIVE.
KETEVAN N GVALIA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0065871. The credential type is controlled substance registration for practitioner. The business address is 170 W. Polk St. Apt. 1007, Chicago, IL 60605. The current status is inactive.
Licensee Name | KETEVAN N GVALIA |
Credential ID | 1430874 |
Credential Number | CSP.0065871 |
Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
Business Address |
170 W. Polk St. Apt. 1007 Chicago IL 60605 |
Business Type | INDIVIDUAL |
Status | INACTIVE - WITHDRAWN |
Refresh Date | 2017-07-14 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1430600 | 1 | Physician/Surgeon | - | INACTIVE |
Street Address | 170 W. Polk St. Apt. 1007 |
City | Chicago |
State | IL |
Zip Code | 60605 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Donald J Wallin | 711 S Dearborn St Ste 606, Chicago, IL 60605 | Architect | 2020-08-01 ~ 2021-07-31 |
Mark M Borniak | 1160 S Michiagan Ave Unit 3704, Chicago, IL 60605 | Real Estate Broker | 2020-06-02 ~ 2021-03-31 |
Kristopher Scott Lejeune | 1326 S Michigan Avenue, Chicago, IL 60605 | Registered Nurse | 2020-06-02 ~ 2021-01-31 |
Martin S Barenbaum | 1530 S State St #15m, Chicago, IL 60605 | Professional Engineer | 2018-02-01 ~ 2019-01-31 |
Rudomino Library Counseil Usa | 888 South Michigan Avenue, #403, Chicago, IL 60605 | Public Charity-exempt From Financial Requirements | ~ |
Theangya P Lee | 1130 So Michigan Ave#3606, Chicago, IL 60605 | Professional Engineer | 1993-12-17 ~ 1995-01-31 |
Stanley Slazas IIi · % Wma | Attn Stanley Slazas IIi, Chicago, IL 60605 | Professional Engineer | 2005-02-01 ~ 2006-01-31 |
World Health Imaging Telemedicine and Informatics Alliance | 47 W. Polk Street, Suite 100-289, Chicago, IL 60605 | Public Charity | 2009-05-18 ~ 2010-05-31 |
Neil P Frankel | 727 S Dearborn St, Chicago, IL 60605 | Architect | 2000-08-17 ~ 2001-07-31 |
Lorraine Goodwin | 525 S Dearborn, Chicago, IL 60605 | Registered Nurse | 1994-01-14 ~ 1995-03-31 |
Find all Licenses in zip 60605 |
City | Chicago |
Zip Code | 60605 |
License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Chicago |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Ketevan Kiguradze Dds | 106 Noroton Ave, Darien, CT 06820 | Controlled Substance Registration for Practitioner | 2019-03-18 ~ 2021-02-28 |
Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
Kaushik Roy | Apt A2, Farmington, CT 06032-1249 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).