Michael D Gentile Controlled Substance Registration for Practitioner
49 Lake Ave, Greenwich, CT 06830


Michael D Gentile is licensed in the eLicensing system of Connecticut. The license credential ID is 209317. The license type is CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER. The license status is ACTIVE. The address is 49 Lake Ave, Greenwich, CT 06830. The zip code is 06830.


Michael D Gentile · 49 Lake Ave, Greenwich, CT 06830

Credential ID 209317
Name MICHAEL D GENTILE
Type INDIVIDUAL
Address 49 LAKE AVE
GREENWICH, CT 06830
License Credential CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Full Credential Code CSP.0027904
Credential Type CSP
Credential Number 27904
Status ACTIVE
Status Reason CURRENT
Active 1
Issue Date 03/24/2006
Effective Date 03/01/2015
Expiration Date 02/28/2017
Record Refresh Date 02/23/201

street_number: 49
route: Lake Avenue (Lake Ave)
locality, political: Greenwich
admin_level_2, political: Fairfield County
admin_level_1, political: Connecticut (CT)
country, political: United States (US)
postal_code: 06830
types : street_address
latitude: 41.032862
longitude: -73.6309851
latlng: (41.032862, -73.6309851)


MICHAEL D GENTILE · Connecticut Business

Michael D Gentile · Dentist 49 Lake Ave, Greenwich, CT 06830

Zip 06830 · Controlled Substance Registration for Practitioner · Connecticut Business

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