Connecticut
Department of Consumer Protection
SUSADA INTHAVONG
Controlled Substance Registration for Practitioners
License number
CSP.0044902
Date granted
03/01/2013
Date expires
02/28/2015
Class
Controlled Substance Registration for Practitioners
Status
Active
Address
WINDSOR LOCKS, CT, 06096-2815
ctlicensing.org
ID 353241
LAST UPDATED 2024-05-06 11:58:32 UTC
LAST UPDATED 2024-05-06 11:58:32 UTC
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