KEALA K LANDRY MD
Controlled Substance Registration for Practitioner


Address: 4102 Avalon Gates, Trumbull, CT 06611

KEALA K LANDRY MD (Credential# 347549) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is February 29, 2004. The license expiration date date is February 28, 2005. The license status is INACTIVE.

Business Overview

KEALA K LANDRY MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0033971. The credential type is controlled substance registration for practitioner. The effective date is February 29, 2004. The expiration date is February 28, 2005. The business address is 4102 Avalon Gates, Trumbull, CT 06611. The current status is inactive.

Basic Information

Licensee Name KEALA K LANDRY MD
Credential ID 347549
Credential Number CSP.0033971
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 4102 Avalon Gates
Trumbull
CT 06611
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2004-02-29
Expiration Date 2005-02-28
Refresh Date 2009-01-26

Other licenses

ID Credential Code Credential Type Issue Term Status
559335 1.041752 Physician/Surgeon 2003-08-08 2003-08-08 - 2004-05-31 INACTIVE

Office Location

Street Address 4102 AVALON GATES
City TRUMBULL
State CT
Zip Code 06611

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Competitor

Search similar business entities

City TRUMBULL
Zip Code 06611
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + TRUMBULL

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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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