LAWRENCE JOSEPH BAHOURA (Credential# 1611285) 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.
LAWRENCE JOSEPH BAHOURA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0069786. 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 5333 Mcauley Dr Rm 6016, Ypsilanti, MI 48197-1005. The current status is inactive.
| Licensee Name | LAWRENCE JOSEPH BAHOURA |
| Credential ID | 1611285 |
| Credential Number | CSP.0069786 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
5333 Mcauley Dr Rm 6016 Ypsilanti MI 48197-1005 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LACK OF ACTIVE MEDICAL LICENSE |
| Issue Date | 2018-10-29 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-04-24 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1604562 | 1.062057 | Physician/Surgeon | 2018-10-24 | 2018-10-24 - 2019-08-31 | INACTIVE |
| Street Address | 5333 MCAULEY DR RM 6016 |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-1005 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael Andrew Fatt | 5333 Mcauley Dr Rm 6016, Ypsilanti, MI 48197-1005 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Ursula Sylvia Knoepp | 5333 Mcauley Dr Rm 6016, Ypsilanti, MI 48197-1005 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Joshua Adam Rubin | 5333 Mcauley Dr Rm 6016, Ypsilanti, MI 48197-1005 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Robert Richter Taila | 5333 Mcauley Dr Rm 6016, Ypsilanti, MI 48197-1005 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sean Edward Theisen | 5333 Mcauley Dr Rm 6016, Ypsilanti, MI 48197-1005 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael James Kasotakis | 5333 Mcauley Dr Rm 6016, Ypsilanti, MI 48197-1005 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Karen Lee Haddlesey | 5333 Mcauley Dr Rm 6016, Ypsilanti, MI 48197-1005 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Donna Louise Hoff | 5333 Mcauley Dr Rm 6016, Ypsilanti, MI 48197-1005 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| James Paul Carl | 5333 Mcauley Dr Rm 6016, Ypsilanti, MI 48197-1005 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Gerald Gene Yutzy | 5333 Mcauley Dr Rm 6016, Ypsilanti, MI 48197-1005 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ramin Blevins Behjatnia | 5333 Mcauley Dr Ste 6016, Ypsilanti, MI 48197-1005 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nader Roy Mohtadi | 5333 Mcauley Dr., Ypsilanti, MI 48197 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Carl C Blackwood | 5613 Hampshire Lane, Ypsilanti, MI 48197 | Advanced Practice Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Alyssa K Copeland | 8808 Amaranth Lane, Ypsilanti, MI 48197 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Marcie M Moore | 200 W Michigan Ave, Ypsilanti, MI 48197 | Registered Nurse | 2016-04-01 ~ 2017-03-31 |
| Ave Maria College of The Americas | 300 W Forest Ave., Ypsilanti, MI 48197 | Public Charity-exempt From Financial Requirements | ~ |
| Eastern Michigan University Foundation | 1349 S. Huron Street, Ypsilanti, MI 48197 | Public Charity-exempt From Financial Requirements | ~ |
| Opal C Williams | 4125 Hawks Cove, Ann Arbor, MI 48197 | Registered Nurse | 2004-07-12 ~ 2005-08-31 |
| Noreen Taylor | P.o. Box 972271, Ypsilanti, MI 48197 | Licensed Practical Nurse | 1984-05-30 ~ 1991-08-31 |
| Regina M Crincoli | 4855 Lakeridge St, Ypsilanti, MI 48197 | Registered Nurse | 2006-05-25 ~ 2007-07-31 |
| Douglas J Holcomb | 1455 Roosevelt, Ypsilanti, MI 48197 | Electrical Unlimited Journeyperson | ~ |
| Find all Licenses in zip 48197 | |||
| City | YPSILANTI |
| Zip Code | 48197 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + YPSILANTI |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Joseph Lawrence Earles | 47 College St, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2019-10-22 ~ 2021-02-28 |
| Joseph Lawrence Chan | 2100 Powell St Ste 900, Emeryville, CA 94608-1844 | Controlled Substance Registration for Practitioner | 2017-02-28 ~ 2019-02-28 |
| Lawrence A Williams | 210 1/2 E 5th St Apt 3, Greenville, NC 27858-1847 | Controlled Substance Registration for Practitioner | 2011-07-22 ~ 2013-02-28 |
| Lawrence P Ryan Dds | 11 S Main St, Marlborough, CT 06447-1553 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lawrence S Christian Dmd | 625 Hopmeadow St, Simsbury, CT 06070 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Brandon D Lawrence | 126 Oldfield Rd, Fairfield, CT 06824 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Lawrence Earl | 71 Collis Ln, Chester, NJ 07930-2204 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Lawrence A Maayan | Chop, Philadelphia, PA 19104 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lawrence S. Pan | 1450 Chapel St # 136, New Haven, CT 06511-4405 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Cheryl M Irizarry | 24 Lawrence Dr, Lebanon, CT 06249 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on LAWRENCE JOSEPH BAHOURA.
| 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).