SIVA PADMANABHAN SIVAKUMAR (Credential# 1067308) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is December 18, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
SIVA PADMANABHAN SIVAKUMAR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0052324. The credential type is controlled substance registration for practitioner. The effective date is December 18, 2019. The expiration date is February 28, 2021. The business address is 38 Ericka Cicle, East Longmeadow, MA 01028. The current status is active.
| Licensee Name | SIVA PADMANABHAN SIVAKUMAR |
| Credential ID | 1067308 |
| Credential Number | CSP.0052324 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
38 Ericka Cicle East Longmeadow MA 01028 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2012-04-25 |
| Effective Date | 2019-12-18 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-12-19 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1054001 | 1.050827 | Physician/Surgeon | 2012-04-19 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 38 ERICKA CICLE |
| City | EAST LONGMEADOW |
| State | MA |
| Zip Code | 01028 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kathleen Stezko | 29 Autumn Ridge, East Longmeadow, MA 01028 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Sergy Chebotarev | 38 Lenox Circle, East Longmeadow, MA 01028 | Tax Preparer/facilitator Permit | 2020-06-18 ~ 2022-06-30 |
| Breanna Lynn Cloonan | 11 Acorn Street, East Longmeadow, MA 01028 | Physical Therapist Assistant | 2020-07-01 ~ 2021-06-30 |
| Maureen Teresa Blanchard | 70 Somers Rd, East Longmeadow, MA 01028 | Esthetician | ~ |
| Erica J Mcnamara | 30 Villanova Street, East Longmeadow, MA 01028 | Real Estate Salesperson | 2020-06-15 ~ 2021-05-31 |
| Jerry E Gray | C/o Abide Inc., East Longmeadow, MA 01028 | Lead Abatement Supervisor | 2020-09-01 ~ 2021-08-31 |
| Devin T Mccorison | C/o Abide, Inc., East Longmeadow, MA 01028 | Asbestos Abatement Supervisor | 2020-09-01 ~ 2021-08-31 |
| Susan B Chunyk | Hampden Hearing Ctr, East Longmeadow, MA 01028 | Audiologist | 2020-08-01 ~ 2021-07-31 |
| Mario Tascon | 202 Canterbury Circle, East Longmeadow, MA 01028 | Real Estate Salesperson | 2020-06-08 ~ 2021-05-31 |
| Jeong Ja Lee | 25 Robin St, East Longmeadow, MA 01028 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Find all Licenses in zip 01028 | |||
| City | EAST LONGMEADOW |
| Zip Code | 01028 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + EAST LONGMEADOW |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Padmanabhan Premkumar | 62 Franks Way, South Windsor, CT 06074 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Subra - Siva Md | 30 Ridgewood Rd, Woodbury, CT 06798-3814 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Kirubakaran Siva | 80 Winter Ln, Tewksbury, MA 01876-2256 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Pradeepa Padmanabhan Dds | 6 White Pine Terrace, Weatogue, CT 06089 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kirubakaran Siva | 5305 Archstone Ave, Tewksbury, MA 01876-1872 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Siva Yadlapati Md · Univ of Conn Health Ctr | Div of Homatology/oncology, Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 1998-03-01 ~ 1999-02-28 |
| Siva Construction Inc | 17 Lafayette Avenue, Ridgefield, CT 06877 | Home Improvement Contractor | 1995-02-01 ~ 1995-11-30 |
| Sergio I Vazquez · Siva Construction Co Inc | 17 Lafayette Ave, Ridgefield, CT 06877 | Home Improvement Contractor | 1995-02-21 ~ 1995-11-30 |
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
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| 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).