ROBERT D RUSSO SR
Controlled Substance Registration for Practitioner


Address: 180 Brooklawn Avenue, Bridgeport, CT 06601

ROBERT D RUSSO SR (Credential# 152062) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 1998. The license expiration date date is February 28, 1999. The license status is INACTIVE.

Business Overview

ROBERT D RUSSO SR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0001794. The credential type is controlled substance registration for practitioner. The effective date is March 1, 1998. The expiration date is February 28, 1999. The business address is 180 Brooklawn Avenue, Bridgeport, CT 06601. The current status is inactive.

Basic Information

Licensee Name ROBERT D RUSSO SR
Credential ID 152062
Credential Number CSP.0001794
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 180 Brooklawn Avenue
Bridgeport
CT 06601
Business Type INDIVIDUAL
Status INACTIVE - DOES NOT WISH TO RENEW
Effective Date 1998-03-01
Expiration Date 1999-02-28
Refresh Date 2004-04-23

Other licenses

ID Credential Code Credential Type Issue Term Status
538410 1.004735 Physician/Surgeon 1943-08-13 1997-06-13 - 1998-08-31 INACTIVE

Office Location

Street Address 180 BROOKLAWN AVENUE
City BRIDGEPORT
State CT
Zip Code 06601

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Competitor

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City BRIDGEPORT
Zip Code 06601
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRIDGEPORT

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Anthony J Russo Dds 85 Prospect St, Milford, CT 06460 Controlled Substance Registration for Practitioner 2007-03-01 ~ 2008-02-29
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Nicolas J Pulham 290 Russo Drive, Hamden, CT 06518 Controlled Substance Registration for Practitioner 2015-03-01 ~ 2017-02-28
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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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