JOHVONNE M CLAYBOURNE DO
Controlled Substance Registration for Practitioner


Address: 6 Seneca Rd, West Hartford, CT 06117

JOHVONNE M CLAYBOURNE DO (Credential# 397569) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.

Business Overview

JOHVONNE M CLAYBOURNE DO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0037085. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2015. The expiration date is February 28, 2017. The business address is 6 Seneca Rd, West Hartford, CT 06117. The current status is inactive.

Basic Information

Licensee Name JOHVONNE M CLAYBOURNE DO
Credential ID 397569
Credential Number CSP.0037085
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 6 Seneca Rd
West Hartford
CT 06117
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2005-03-08
Effective Date 2015-03-01
Expiration Date 2017-02-28
Refresh Date 2018-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
560220 1.042638-DO Physician/Surgeon 2004-07-08 2015-05-01 - 2016-04-30 INACTIVE

Office Location

Street Address 6 SENECA RD
City WEST HARTFORD
State CT
Zip Code 06117

Licenses in the same location

Licensee Name Office Address Credential Effective / Expiration
David R Goldberg 6 Seneca Rd, West Hartford, CT 06117 Real Estate Salesperson 2004-02-09 ~ 2004-05-31

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Competitor

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City WEST HARTFORD
Zip Code 06117
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WEST HARTFORD

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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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