VIRAL A DAVE MD
Controlled Substance Registration for Practitioner


Address: 8102 Avalon Gates, Trumbull, CT 06611

VIRAL A DAVE MD (Credential# 476929) 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

VIRAL A DAVE MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0041906. 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 8102 Avalon Gates, Trumbull, CT 06611. The current status is inactive.

Basic Information

Licensee Name VIRAL A DAVE MD
Credential ID 476929
Credential Number CSP.0041906
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 8102 Avalon Gates
Trumbull
CT 06611
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2007-07-19
Effective Date 2009-03-01
Expiration Date 2011-02-28
Refresh Date 2013-03-07

Other licenses

ID Credential Code Credential Type Issue Term Status
563147 1.045565 Physician/Surgeon 2007-06-25 2010-02-01 - 2011-01-31 INACTIVE

Office Location

Street Address 8102 AVALON GATES
City TRUMBULL
State CT
Zip Code 06611

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Competitor

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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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