SHRUTI A SHUKLA (Credential# 1076078) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
SHRUTI A SHUKLA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.051186. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 8003 Inverness Lakes Trl, Fort Wayne, IN 46804-3845. The current status is active.
| Licensee Name | SHRUTI A SHUKLA |
| Credential ID | 1076078 |
| Credential Number | 1.051186 |
| Credential Type | Physician/Surgeon |
| Business Address |
8003 Inverness Lakes Trl Fort Wayne IN 46804-3845 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2012-07-13 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-04-09 |
| Street Address | 8003 INVERNESS LAKES TRL |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-3845 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sco Engineering LLC | 6534 Constitution Drive, Fort Wayne, IN 46804 | Professional Engineering Corporation | 2020-06-24 ~ 2021-06-12 |
| Summit Outdoors LLC | 6714 Pointe Inverness Way, Fort Wayne, IN 46804 | Importer of Bedding & Upholstered Furniture | 2020-05-01 ~ 2021-04-30 |
| Keith David Clancy | 7900 West Jefferson Blvd, Fort Wayne, IN 46804 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Ralph G Fetter Jr · Hamilton Standard | 7529 Amber Rd, Fort Wayne, IN 46804 | Professional Engineer | 1989-03-02 ~ 1990-01-31 |
| Jerry L Thompson | 3423 St. Alban Court, Fort Wayne, IN 46804 | Professional Engineer | 2003-02-01 ~ 2004-01-31 |
| Marta E Wrobleski | 2423 Lake Ridge Dr, Fort Wayne, IN 46804 | Registered Nurse | 2011-02-01 ~ 2012-01-31 |
| Shirley F Shiff | 6109 Waterside Dr, Fort Wayne, IN 46804 | Psychologist | 1994-09-19 ~ 1995-08-31 |
| Julianne Christenson | 10819 Mohave Court, Ft Wayne, IN 46804 | Registered Nurse | 2007-06-25 ~ 2008-07-31 |
| Antibus Scales & Systems Inc · Phillip D Antibus | 4809 Illinois Rd, Fort Wayne, IN 46804 | Dealer of Weighing & Measuring Devices | 2000-01-01 ~ 2000-12-31 |
| Mark Joseph Minnie | 4322 Cadillac Dr, Ft Wayne, IN 46804 | Pharmacist | 2004-02-09 ~ 2005-01-31 |
| Find all Licenses in zip 46804 | |||
| City | FORT WAYNE |
| Zip Code | 46804 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + FORT WAYNE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Shruti Shukla | 17 Harbor Bay Cir, Laurence Harbor, NJ 08879-2920 | Dentist | 2010-04-23 ~ 2011-02-28 |
| Shruti Kumar | 44 Uplands Way, Glastonbury, CT 06033-3357 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Shruti Deopujari | 330 W Brambleton Avenue, Norfolk, VA 23510 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Shruti P Mutalik | 3775 63rd St Apt B39, Woodside, NY 11377-2664 | Physician/surgeon | 2014-02-25 ~ 2014-12-31 |
| Pratibha S Shukla | 9 Elizabeth Street, West Haven, CT 06516 | Physician/surgeon | 2002-05-30 ~ 2003-04-30 |
| Anshu Shukla | 900 23rd St Nw, Washington, DC 20037 | Resident Physician | 2015-06-25 ~ 2019-06-30 |
| Anant Shukla | 267 Grant St., Bridgeport, CT 06610 | Resident Physician | 2019-06-24 ~ 2022-06-30 |
| Shikha Shukla | 20 York Street, New Haven, CT 06510 | Resident Physician | 2019-07-01 ~ 2020-06-30 |
| Prateek Shukla | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2018-06-28 ~ 2019-06-30 |
| Kunjan N Shukla | 604 Woodbridge Commons Way, Iselin, NJ 08830-3021 | Professional Engineer | 2012-02-01 ~ 2013-01-31 |
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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).