PAUL T PITLICK MD
Controlled Substance Registration for Practitioner


Address: 2139 High St, Palo Alto, CA 94301-3928

PAUL T PITLICK MD (Credential# 516185) 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

PAUL T PITLICK MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0044704. 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 2139 High St, Palo Alto, CA 94301-3928. The current status is inactive.

Basic Information

Licensee Name PAUL T PITLICK MD
Credential ID 516185
Credential Number CSP.0044704
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 2139 High St
Palo Alto
CA 94301-3928
Business Type INDIVIDUAL
Status INACTIVE - DOES NOT WISH TO RENEW
Issue Date 2008-10-16
Effective Date 2009-03-01
Expiration Date 2011-02-28
Refresh Date 2010-11-02

Other licenses

ID Credential Code Credential Type Issue Term Status
564608 1.047026 Physician/Surgeon 2008-09-24 2009-05-05 - 2010-05-31 INACTIVE

Office Location

Street Address 2139 HIGH ST
City PALO ALTO
State CA
Zip Code 94301-3928

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Competitor

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City PALO ALTO
Zip Code 94301
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PALO ALTO

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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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