ANITA R VANDERSTELT (Credential# 1408453) 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 PENDING.
ANITA R VANDERSTELT is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.056365-DO. The credential type is physician/surgeon. The effective date is August 1, 2018. The expiration date is July 31, 2019. The business address is 6225 Wertz, Davisburg, MI 48350-3547. The current status is pending.
| Licensee Name | ANITA R VANDERSTELT |
| Credential ID | 1408453 |
| Credential Number | 1.056365-DO |
| Credential Type | Physician/Surgeon |
| Credential SubCategory | DO |
| Business Address |
6225 Wertz Davisburg MI 48350-3547 |
| Business Type | INDIVIDUAL |
| Status | PENDING - REINSTATEMENT APPLICATION PENDING |
| Issue Date | 2017-04-20 |
| Effective Date | 2018-08-01 |
| Expiration Date | 2019-07-31 |
| Refresh Date | 2020-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1419323 | CSP.0065241 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-04-21 | 2017-04-21 - 2019-02-28 | LAPSED |
| Street Address | 6225 WERTZ |
| City | DAVISBURG |
| State | MI |
| Zip Code | 48350-3547 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Barbara A Kin | 8268 Pine Lake Dr, Davisburg, MI 48350 | Advanced Practice Registered Nurse | 1993-01-25 ~ 1993-11-30 |
| Brooke D Marcoccia | 9303 Osprey Bay Cr., Davisburg, MI 48350 | Physical Therapist Assistant | 2005-08-31 ~ 2006-11-01 |
| City | DAVISBURG |
| Zip Code | 48350 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + DAVISBURG |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Anita Grover | Po Box 115, Bridgewater, CT 06752-0115 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Anita Karne Md | 115 Linden St, New Haven, CT 06511-2424 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Anita Nair | 12 Green St, Congers, NY 10920-2307 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Anita Bhagavath | 15 Collingwood Dr, Huntington Station, NY 11746 | Physician/surgeon | 2018-09-19 ~ 2019-05-31 |
| Anita M Lopker Md | 18 Burr Road, Westport, CT 06880 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Anita D Bhole | 1 Mancuso Drive, Ossining, NY 10562 | Physician/surgeon | 1985-01-03 ~ 1986-11-30 |
| Anita L Licata | 1460 Elm Street, Stratford, CT 06497 | Physician/surgeon | 1981-01-01 ~ 1994-01-31 |
| Anita Chu | Rensselaer Polytechnic Institute, Troy, NY 12180 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Anita S Arora | 62 Norton Avenue, Guilford, CT 06437 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Anita G Beneke Md | 134 Stillson Road, Fairfield, CT 06432-3212 | Physician/surgeon | 2001-11-20 ~ 2003-01-31 |
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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).