GIL M FERNANDEZ MD
Controlled Substance Registration for Practitioner


Address: 4355 S National Ave Apt 1510, Springfield, MO 65810-2666

GIL M FERNANDEZ MD (Credential# 893023) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.

Business Overview

GIL M FERNANDEZ MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0046428. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2011. The expiration date is February 28, 2013. The business address is 4355 S National Ave Apt 1510, Springfield, MO 65810-2666. The current status is inactive.

Basic Information

Licensee Name GIL M FERNANDEZ MD
Credential ID 893023
Credential Number CSP.0046428
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 4355 S National Ave Apt 1510
Springfield
MO 65810-2666
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2009-08-28
Effective Date 2011-03-01
Expiration Date 2013-02-28
Refresh Date 2014-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
884044 1.048058 Physician/Surgeon 2009-08-13 2011-03-01 - 2012-02-29 INACTIVE

Office Location

Street Address 4355 S NATIONAL AVE APT 1510
City SPRINGFIELD
State MO
Zip Code 65810-2666

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Competitor

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City SPRINGFIELD
Zip Code 65810
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SPRINGFIELD

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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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