MARJAN MOGHADAM
Dentist


Address: 420 E 64th St Apt W3f, New York, NY 10065-7862

MARJAN MOGHADAM (Credential# 968977) is licensed (Dentist) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.

Business Overview

MARJAN MOGHADAM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #2.010388. The credential type is dentist. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 420 E 64th St Apt W3f, New York, NY 10065-7862. The current status is active.

Basic Information

Licensee Name MARJAN MOGHADAM
Credential ID 968977
Credential Number 2.010388
Credential Type Dentist
Business Address 420 E 64th St Apt W3f
New York
NY 10065-7862
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2010-10-06
Effective Date 2020-06-01
Expiration Date 2021-05-31
Refresh Date 2020-05-04

Other licenses

ID Credential Code Credential Type Issue Term Status
992252 CSP.0049918 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2011-04-08 2019-03-01 - 2021-02-28 ACTIVE

Office Location

Street Address 420 E 64TH ST APT W3F
City NEW YORK
State NY
Zip Code 10065-7862

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Competitor

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City NEW YORK
Zip Code 10065
License Type Dentist
License Type + County Dentist + NEW YORK

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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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