ANDERS GUSTAF AULEN HOLM MD
Controlled Substance Registration for Practitioner


Address: 25 Old Mountain Road, Farmington, CT 06032

ANDERS GUSTAF AULEN HOLM MD (Credential# 205018) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2001. The license expiration date date is February 28, 2002. The license status is INACTIVE.

Business Overview

ANDERS GUSTAF AULEN HOLM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0027696. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2001. The expiration date is February 28, 2002. The business address is 25 Old Mountain Road, Farmington, CT 06032. The current status is inactive.

Basic Information

Licensee Name ANDERS GUSTAF AULEN HOLM MD
Credential ID 205018
Credential Number CSP.0027696
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 25 Old Mountain Road
Farmington
CT 06032
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2001-03-01
Expiration Date 2002-02-28
Refresh Date 2009-01-26

Other licenses

ID Credential Code Credential Type Issue Term Status
554955 1.037365 Physician/Surgeon 1998-11-06 2000-06-23 - 2001-06-30 INACTIVE

Office Location

Street Address 25 OLD MOUNTAIN ROAD
City FARMINGTON
State CT
Zip Code 06032

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Competitor

Search similar business entities

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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