JOLOMI T IKOMI MD
Controlled Substance Registration for Practitioner


Address: 500 Bedford St Apt 343, Stamford, CT 06901-1510

JOLOMI T IKOMI MD (Credential# 938711) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.

Business Overview

JOLOMI T IKOMI MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0047883. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2013. The expiration date is February 28, 2015. The business address is 500 Bedford St Apt 343, Stamford, CT 06901-1510. The current status is inactive.

Basic Information

Licensee Name JOLOMI T IKOMI MD
Credential ID 938711
Credential Number CSP.0047883
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 500 Bedford St Apt 343
Stamford
CT 06901-1510
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2010-07-08
Effective Date 2013-03-01
Expiration Date 2015-02-28
Refresh Date 2016-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
919566 1.048600 Physician/Surgeon 2010-03-30 2013-12-01 - 2014-11-30 INACTIVE

Office Location

Street Address 500 BEDFORD ST APT 343
City STAMFORD
State CT
Zip Code 06901-1510

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Jennifer B Berger 500 Bedford St Apt 341, Stamford, CT 06901-1510 Speech and Language Pathologist 2017-08-01 ~ 2018-07-31

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Competitor

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City STAMFORD
Zip Code 06901
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + STAMFORD

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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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