TEIDE BRISIBE MD (Credential# 995744) 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.
TEIDE BRISIBE MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0050057. 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 803 Heatherhaven Dr, Ballwin, MO 63011. The current status is inactive.
Licensee Name | TEIDE BRISIBE MD |
Credential ID | 995744 |
Credential Number | CSP.0050057 |
Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
Business Address |
803 Heatherhaven Dr Ballwin MO 63011 |
Business Type | INDIVIDUAL |
Status | INACTIVE |
Issue Date | 2011-05-05 |
Effective Date | 2013-03-01 |
Expiration Date | 2015-02-28 |
Refresh Date | 2017-05-02 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
980318 | 1.049605 | Physician/Surgeon | 2011-03-21 | 2012-01-01 - 2012-12-31 | INACTIVE |
Street Address | 803 HEATHERHAVEN DR |
City | BALLWIN |
State | MO |
Zip Code | 63011 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Thomas D Auer | 2111 Dartmouth Gate Court, Wildwood, MO 63011 | Architect | 2020-08-01 ~ 2021-07-31 |
Michelle Renee Wines | 16344 Hickory Pine Lane, Wildwood, MO 63011 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
Mark Erin Reed | 496 Thunderhead Canyon Drive, Wildwood, MO 63011 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
Bridgette Collins | 127 Steamboat Ln, Ballwin, MO 63011 | Registered Nurse | 2018-09-01 ~ 2019-08-31 |
Thomas A Tyler | 450 Weidman Road, Ballwin, MO 63011 | Architect | 2019-08-01 ~ 2020-07-31 |
Friends of The Children's Eternal Rainforest | 1324 Clarkson Clayton Center, #312, St. Louis, MO 63011 | Public Charity | 2017-04-28 ~ 2017-11-30 |
Umonoibalo Ehimare Md | 803 Heatherhaven Drive, Ballwin, MO 63011 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
Mathew R Wohlberg | 1516 Towne Drive, Ellisville, MO 63011 | Professional Engineer | 2010-02-01 ~ 2011-01-31 |
Michael J Mcginnis | 1008 Van Loon Dr, Manchester, MO 63011 | Professional Engineer | 1989-03-20 ~ 1990-01-31 |
James Henry Gill | 121 Steamboat Ln Apt #1, Ballwin, MO 63011 | Professional Engineer | 1999-11-16 ~ 2001-01-31 |
Find all Licenses in zip 63011 |
City | BALLWIN |
Zip Code | 63011 |
License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BALLWIN |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
Zhi Xin Xu Md | 47-46 190th St, Flushing, NY 11358 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
Ria M Lim | 111 Ledgewood Rd Apt 305, Groton, CT 06340 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
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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).