DEEPA V SHAH MD
Controlled Substance Registration for Practitioner


Address: 77 Park Ave #1401, Hoboken, NJ 07030

DEEPA V SHAH MD (Credential# 480248) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is August 16, 2007. The license expiration date date is February 29, 2008. The license status is INACTIVE.

Business Overview

DEEPA V SHAH MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0042473. The credential type is controlled substance registration for practitioner. The effective date is August 16, 2007. The expiration date is February 29, 2008. The business address is 77 Park Ave #1401, Hoboken, NJ 07030. The current status is inactive.

Basic Information

Licensee Name DEEPA V SHAH MD
Credential ID 480248
Credential Number CSP.0042473
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 77 Park Ave #1401
Hoboken
NJ 07030
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2007-08-16
Effective Date 2007-08-16
Expiration Date 2008-02-29
Refresh Date 2009-02-05

Other licenses

ID Credential Code Credential Type Issue Term Status
562890 1.045308 Physician/Surgeon 2007-04-19 2007-04-19 - 2007-12-31 INACTIVE

Office Location

Street Address 77 PARK AVE #1401
City HOBOKEN
State NJ
Zip Code 07030

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Competitor

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City HOBOKEN
Zip Code 07030
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + HOBOKEN

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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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