MARA F CUBEROS GUEVARA
Controlled Substance Registration for Practitioner


Address: 211 Main St Apt 37, Farmington, CT 06032-2966

MARA F CUBEROS GUEVARA (Credential# 1439129) 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 INACTIVE.

Business Overview

MARA F CUBEROS GUEVARA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0066365. 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 211 Main St Apt 37, Farmington, CT 06032-2966. The current status is inactive.

Basic Information

Licensee Name MARA F CUBEROS GUEVARA
Credential ID 1439129
Credential Number CSP.0066365
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 211 Main St Apt 37
Farmington
CT 06032-2966
Business Type INDIVIDUAL
Status INACTIVE - LACK OF ACTIVE MEDICAL LICENSE
Issue Date 2017-07-31
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2020-04-23

Other licenses

ID Credential Code Credential Type Issue Term Status
1488130 2.012007-RES Resident Dentist 2017-07-01 2017-07-01 - 2019-06-30 INACTIVE

Office Location

Street Address 211 MAIN ST APT 37
City FARMINGTON
State CT
Zip Code 06032-2966

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Michael B Mclain 211 Main St, Farmington, CT 06032-2966 Emergency Medical Technician 2011-04-15 ~ 2013-10-01

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Competitor

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City FARMINGTON
Zip Code 06032
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FARMINGTON

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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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