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Licensed Professional Information:
Medical Doctor 4301500275


 

Licensee Detail

 
CONTROLLED SUBSTANCE LIST

City:

New York

State or Province:

New York

ZIP or Postal Code:

1017

CS Record Number:

5315210455

CS Status:

Active

CS Expiration Date:

09/27/2025

DRUG CONTROL LIST

City:

New York

State:

New York

ZIP Code:

10017

DC Record Number:

5307007688APP19

DC Status:

Pending

 
 

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