SHAFIULLA KHAN DDS
Controlled Substance Registration for Practitioner


Address: 4154 Madison Ave, Trumbull, CT 06611

SHAFIULLA KHAN DDS (Credential# 389484) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2009. The license expiration date date is February 28, 2011. The license status is INACTIVE.

Business Overview

SHAFIULLA KHAN DDS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0036757. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2009. The expiration date is February 28, 2011. The business address is 4154 Madison Ave, Trumbull, CT 06611. The current status is inactive.

Basic Information

Licensee Name SHAFIULLA KHAN DDS
Credential ID 389484
Credential Number CSP.0036757
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 4154 Madison Ave
Trumbull
CT 06611
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2004-11-09
Effective Date 2009-03-01
Expiration Date 2011-02-28
Refresh Date 2013-03-07

Office Location

Street Address 4154 MADISON AVE
City TRUMBULL
State CT
Zip Code 06611

Licenses in the same location

Licensee Name Office Address Credential Effective / Expiration
John J Bogannam 4154 Madison Ave, Trumbull, CT 06611 Chiropractor 2020-06-01 ~ 2021-05-31
Dorrance T Kelly 4154 Madison Ave, Trumbull, CT 06611-3563 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Mohammed M Imam Dds 4154 Madison Ave, Trumbull, CT 06611 Controlled Substance Registration for Practitioner 2009-03-20 ~ 2011-02-28

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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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