SANJIV PRABHU (Credential# 1340419) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2018. The license expiration date date is July 31, 2019. The license status is INACTIVE.
SANJIV PRABHU is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.055428. The credential type is physician/surgeon. The effective date is August 1, 2018. The expiration date is July 31, 2019. The business address is 2260 Wrightsboro Rd, Augusta, GA 30904-4764. The current status is inactive.
| Licensee Name | SANJIV PRABHU |
| Credential ID | 1340419 |
| Credential Number | 1.055428 |
| Credential Type | Physician/Surgeon |
| Business Address |
2260 Wrightsboro Rd Augusta GA 30904-4764 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2016-07-06 |
| Effective Date | 2018-08-01 |
| Expiration Date | 2019-07-31 |
| Refresh Date | 2019-11-03 |
| Street Address | 2260 WRIGHTSBORO RD |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-4764 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| David L Booker | 2321 Kings Way, Augusta, GA 30904 | Physician/surgeon | 2017-02-01 ~ 2018-01-31 |
| Change Gangs Virtural Giving Circles Inc · None | 1041 Via Real, Loveland, CO 30904 | Public Charity-exempt From Financial Requirements | 2015-11-20 ~ |
| Thomas J Kile Jr | 2220 Lee St, Augusta, GA 30904 | Pharmacist | 2011-02-01 ~ 2012-01-31 |
| Dominique C Harmon | 792 Eve Street, Augusta, GA 30904 | Licensed Clinical Social Worker | 2004-02-02 ~ 2005-02-28 |
| Buffye Warthaw | 10823 Cooney Circle, Agusta, GA 30904 | Registered Nurse | 2006-12-13 ~ 2007-02-28 |
| Robert W Kogel Md | 2301 Laurel Ln, Augusta, GA 30904-3137 | Controlled Substance Registration for Practitioner | 2019-11-13 ~ 2021-02-28 |
| Dwight Mirmow | 1435 Heard Ave, Augusta, GA 30904-4719 | Physician/surgeon | 2016-02-01 ~ 2017-01-31 |
| Charles W Jones | 1910 Thomas Ln, Augusta, GA 30904-5114 | Architect | 2020-08-01 ~ 2021-07-31 |
| Robert Willson | 1521 Monte Sano Ave, Augusta, GA 30904-5399 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Family Planning Association of Maine Inc | 43 Gabriel Dr, Augusta, ME 04330-7852 | Public Charity | 2019-03-05 ~ 2020-05-31 |
| June Yowtak | 2095 Willhaven Dr, Augusta, GA 30909 | Resident Physician | 2017-07-07 ~ 2021-06-30 |
| Amd Medicom Inc | 4049 Allen Station Rd Ste A, Augusta, GA 30906-8734 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Augusta Medical Systems LLC | 1027 Broad St, Augusta, GA 30901-1142 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Kenny Susanto | 1120 15th St, Augusta, GA 30912 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Elizabeth B Eubanks | 2829 Lombardy Ct, Augusta, GA 30909-3901 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Yumeris De Jesus Baez | 2803 Ridgecrest Dr, Augusta, GA 30907-4821 | Registered Nurse | ~ |
| Carrie Lynn Wimer | 165 Queen Dr, Augusta, WV 26704-7643 | Registered Nurse - Temporary | 2020-04-30 ~ 2020-08-28 |
| Richard J Raskin | 15 Enterprise Dr, Augusta, ME 04330-7997 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Glenn A Calabrese | 2 Grant Ct, Augusta, NJ 07822-2158 | Asbestos Consultant-inspector | 2020-03-01 ~ 2021-02-28 |
| Find all Licenses in AUGUSTA | |||
| City | AUGUSTA |
| Zip Code | 30904 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + AUGUSTA |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Prabhu LLC · Barts Luncheonette | 55 Palisado Ave, Windsor, CT 06095 | Frozen Dessert Retailer | 2005-01-01 ~ 2005-12-31 |
| Sanjiv Kashyap Pa | 29 Fairy Dell Road, Clinton, CT 06413 | Physician Assistant | 2005-09-29 ~ 2006-11-30 |
| Sanjiv Chadha | 130 S Canal St, Chicago, IL 60606-3901 | Architect | 2019-09-18 ~ 2020-07-31 |
| Gauri S Prabhu | 36 Snowberry Ln, Unionville, CT 06085-1574 | Pharmacy Technician | 2020-04-01 ~ 2021-03-31 |
| Ramaswamy S Prabhu | 536 St Lauren Way, Birmingham, AL 35242 | Professional Engineer | 2008-02-01 ~ 2009-01-31 |
| Kishore S Prabhu | 11 Rector St, Bethel, CT 06801 | Professional Engineer | ~ |
| Prabhu D Gianchandani | 2 Morning Glory Cir, Mullica Hill, NJ 08062-2628 | Professional Engineer | 2013-02-01 ~ 2014-01-31 |
| Prabhu D Persaud | 1056 Blue Hills Ave, Bloomfield, CT 06002 | Hairdresser/cosmetician | 2000-04-21 ~ 2001-06-30 |
| Sanjiv Kumar · Burgerfi | 530 Bushy Hill Rd Ste 3b, Simsbury, CT 06070-2922 | Restaurant Wine & Beer | 2019-09-02 ~ 2021-01-01 |
| Ramdas M Prabhu | 37 Beechwood Rd, Basking Ridge, NJ 07920-1714 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
Please comment or provide details below to improve the information on SANJIV PRABHU.
| 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).