VIBHA G GAUTAM (Credential# 1409093) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
VIBHA G GAUTAM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0064908. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 393 Ocean Ave, New London, CT 06320-4717. The current status is active.
| Licensee Name | VIBHA G GAUTAM |
| Credential ID | 1409093 |
| Credential Number | CSP.0064908 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
393 Ocean Ave New London CT 06320-4717 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-03-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 543865 | 1.021848 | Physician/Surgeon | 1980-07-02 | 2019-09-01 - 2020-08-31 | ACTIVE |
| 158212 | CSP.0016957 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2015-03-01 - 2017-02-28 | INACTIVE | |
| 465082 | CSP.0041207 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-03-13 | 2007-03-13 - 2008-02-29 | INACTIVE |
| Street Address | 393 OCEAN AVE |
| City | NEW LONDON |
| State | CT |
| Zip Code | 06320-4717 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John F Cohoon | 397 Ocean Ave, New London, CT 06320-4717 | Registered Nurse | 2017-05-01 ~ 2018-04-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paul R Bourguignon | Nemg, New London, CT 06320 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Stephan Nousiopoulos | 27 Alger Place, New London, CT 06320 | Architect | 2020-08-01 ~ 2021-07-31 |
| Diana Elisabeth Cabrera-mora | 327 Montauk Avenue, New London, CT 06320 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-03-31 |
| Yuhua Han | 18 Anthony Rd Apt H, New London, CT 06320 | Massage Therapist | ~ |
| Empire Pizza · Empire Pizza LLC | 150 Broad St, New London, CT 06320 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Irene C Besser | 19 Hawthorne Dr, New London, CT 06320 | Licensed Nurse Midwife | 2020-09-01 ~ 2021-08-31 |
| Robert F Gardner | 241 Crystal Ave, New London, CT 06320 | Home Improvement Salesperson | 2020-06-26 ~ 2020-11-30 |
| Angie Alejandra Botero Castro | 14 Concord Court, Groton, CT 06320 | Master's Level Social Worker | ~ |
| Kevin J O'reilly | 20 Parkway South, New London, CT 06320 | Psychologist | 2020-09-01 ~ 2021-08-31 |
| Sonny's Market LLC | 324 Jefferson Ave, New London, CT 06320 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06320 | |||
| City | NEW LONDON |
| Zip Code | 06320 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW LONDON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Vibha Murthy | 132 Monroe Tpke, Trumbull, CT 06611-6351 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Gautam R Mirchandani | 111 Morgan St, Stamford, CT 06905 | Controlled Substance Registration for Practitioner | 2019-03-08 ~ 2021-02-28 |
| Shovendra Gautam | 100 Grand St., New Britain, CT 06050 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Arun Gautam | 24 Park Pl Apt 6e, Hartford, CT 06106-5021 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Anil Gautam | 115 Cove Road, Lyme, CT 06371 | Controlled Substance Registration for Practitioner | 1994-08-09 ~ 1996-09-01 |
| 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 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on VIBHA G GAUTAM.
| 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).