SHAHNAZ MOOTABAR APRN
Controlled Substance Registration for Practitioner


Address: 12 Flagler Dr, Rye, NY 10580

SHAHNAZ MOOTABAR APRN (Credential# 303887) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.

Business Overview

SHAHNAZ MOOTABAR APRN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0032011. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2011. The expiration date is February 28, 2013. The business address is 12 Flagler Dr, Rye, NY 10580. The current status is inactive.

Basic Information

Licensee Name SHAHNAZ MOOTABAR APRN
Credential ID 303887
Credential Number CSP.0032011
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 12 Flagler Dr
Rye
NY 10580
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2011-03-01
Expiration Date 2013-02-28
Refresh Date 2014-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
678552 12.000365 Advanced Practice Registered Nurse 1991-05-14 2011-10-01 - 2012-09-30 INACTIVE
566469 10.062458 Registered Nurse 1999-10-22 2011-10-01 - 2012-09-30 INACTIVE

Office Location

Street Address 12 FLAGLER DR
City RYE
State NY
Zip Code 10580

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Competitor

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City RYE
Zip Code 10580
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + RYE

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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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