FAYEZ KOTOB (Credential# 1001652) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
FAYEZ KOTOB is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.050035. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 5050 Villa Linde Pkwy, Suite A, Flint, MI 48532. The current status is active.
| Licensee Name | FAYEZ KOTOB |
| Credential ID | 1001652 |
| Credential Number | 1.050035 |
| Credential Type | Physician/Surgeon |
| Business Address |
5050 Villa Linde Pkwy, Suite A Flint MI 48532 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2011-06-28 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-04-16 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1068728 | CSP.0052366 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2012-05-07 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 5050 Villa Linde Pkwy, Suite A |
| City | Flint |
| State | MI |
| Zip Code | 48532 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Diplomat Speciaty Pharmacy | 3320 Beecher Rd, Flint, MI 48532 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Mark Weiss | 1141 Springborrow Dr, Flint, MI 48532-2141 | Physician/surgeon | 2019-03-01 ~ 2020-02-29 |
| Munawar H Syed | 7147 Granada Dr, Flint, MI 48532-3025 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Crystal Ann Roberts | 522 S Franklin Ave, Flint, MI 48503-5327 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Kettering University | 1700 University Ave, Flint, MI 48504-6214 | Public Charity | 2020-06-01 ~ 2021-05-31 |
| Envoy Health Management LLC | 325 W Atherton Rd, Flint, MI 48507 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Heather Lee Martin | 6331 Lucas Rd, Flint, MI 48506-1225 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Shiva M Reddy | 118 W Pierson Rd, Flint, MI 48505-3348 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Meng Shen | 6223 Maplebrook Ln., Flint, MI 48507 | Physician/surgeon | 2018-09-26 ~ 2019-05-31 |
| Jennifer Lewis | 18357 Woodhollow Drive, Flint, TX 75762 | Registered Nurse | 2018-11-07 ~ 2019-05-31 |
| Diplomat Speciality Pharmacy | 4100 S Saginaw St Ste D, Flint, MI 48507-2605 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Asif Bhimani | 200 E. 1st Street, Flint, MI 48502 | Resident Physician | 2015-06-25 ~ 2019-06-30 |
| Erin E Hicks | 20411 Bluegrass Cir, Flint, TX 75762-8758 | Registered Nurse | 2019-05-01 ~ 2020-04-30 |
| Find all Licenses in Flint | |||
| City | Flint |
| Zip Code | 48532 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Flint |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Fayez G Seif | 500 Central Park Ave, Scarsdale, NY 10583 | Physician/surgeon | 1995-09-01 ~ 1996-10-31 |
| Fayez Shaham · 7-eleven | 257 Reef Rd, Fairfield, CT 06824-6550 | Grocery Beer | 2011-07-07 ~ 2012-06-26 |
| Fayez Ghaly | 37 Pine St, West Haven, CT 06516 | Home Improvement Contractor | 2003-12-01 ~ 2004-11-30 |
| Fayez Seif Md | 500 Central Park Ave, Scrasdale, NY 10583 | Controlled Substance Registration for Practitioner | 1996-06-19 ~ 1997-02-28 |
| Fayez S Ghattas | 7 Haswell Street, Westerly, RI 02891 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Fayez Bechara Jr | 1492 Capitol Ave Unit B204, Bridgeport, CT 06604-1653 | Public Service Technician - Telephone | 2019-10-01 ~ 2020-09-30 |
| Fayez A Ghaly · Anna's Diner | 1765 Meriden-waterbury Road, Southington, CT 06489 | Restaurant Wine & Beer | ~ |
| Fayez A Ghaly · Usa Liquor LLC | 1427 Dixwell Ave, Hamden, CT 06514-4118 | Package Store Liquor | 2011-07-05 ~ 2012-07-01 |
| Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
Please comment or provide details below to improve the information on FAYEZ KOTOB.
| 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).