TEIDE BRISIBE MD
Controlled Substance Registration for Practitioner


Address: 803 Heatherhaven Dr, Ballwin, MO 63011

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.

Business Overview

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.

Basic Information

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

Other licenses

ID Credential Code Credential Type Issue Term Status
980318 1.049605 Physician/Surgeon 2011-03-21 2012-01-01 - 2012-12-31 INACTIVE

Office Location

Street Address 803 HEATHERHAVEN DR
City BALLWIN
State MO
Zip Code 63011

Licenses in the same zip code

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

Competitor

Search similar business entities

City BALLWIN
Zip Code 63011
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BALLWIN

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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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