FRED F MO
Controlled Substance Registration for Practitioner


Address: 5 Sprucetree Ln, Huntington Station, NY 11746-4017

FRED F MO (Credential# 414463) 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

FRED F MO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0038133. 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 5 Sprucetree Ln, Huntington Station, NY 11746-4017. The current status is inactive.

Basic Information

Licensee Name FRED F MO
Credential ID 414463
Credential Number CSP.0038133
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 5 Sprucetree Ln
Huntington Station
NY 11746-4017
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2005-09-20
Effective Date 2009-03-01
Expiration Date 2011-02-28
Refresh Date 2013-03-07

Office Location

Street Address 5 SPRUCETREE LN
City HUNTINGTON STATION
State NY
Zip Code 11746-4017

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Competitor

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City HUNTINGTON STATION
Zip Code 11746
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + HUNTINGTON STATION

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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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