Jerry A Benjamin Pa Controlled Substance Registration for Practitioner
54 Warwick St, West Hartford, CT 06119


Jerry A Benjamin Pa is licensed in the eLicensing system of Connecticut. The license credential ID is 335567. The license type is CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER. The license status is ACTIVE. The address is 54 Warwick St, West Hartford, CT 06119. The zip code is 06119.


Jerry A Benjamin Pa · 54 Warwick St, West Hartford, CT 06119

Credential ID 335567
Name JERRY A BENJAMIN PA
Type INDIVIDUAL
Address 54 WARWICK ST
WEST HARTFORD, CT 06119
License Credential CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Full Credential Code CSP.0033406
Credential Type CSP
Credential Number 33406
Status ACTIVE
Status Reason CURRENT
Active 1
Effective Date 03/01/2015
Expiration Date 02/28/2017
Record Refresh Date 01/26/201

JERRY A BENJAMIN PA · Connecticut Business

Jerry A Benjamin Pa · Controlled Substance Registration for Practitioner 54 Warwick St, West Hartford, CT 06119
Jerry A Benjamin Pa · Physician Assistant 54 Warwick St, West Hartford, CT 06119

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