PRIYADARSHINI BALASUBRAMANIAN (Credential# 1489218) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is INACTIVE.
PRIYADARSHINI BALASUBRAMANIAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.058464-RES. The credential type is resident physician. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 3336 Fairfield Ave Apt 302, Bridgeport, CT 06605-3288. The current status is inactive.
| Licensee Name | PRIYADARSHINI BALASUBRAMANIAN |
| Credential ID | 1489218 |
| Credential Number | 1.058464-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
3336 Fairfield Ave Apt 302 Bridgeport CT 06605-3288 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - INACTIVE |
| Issue Date | 2017-07-01 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-05-12 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1366336 | CSP.0063506 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-07-14 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 1631923 | 1.063579 | Physician/Surgeon | 2019-06-04 | 2019-12-01 - 2020-11-30 | ACTIVE |
| Street Address | 3336 FAIRFIELD AVE APT 302 |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06605-3288 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Krishna Sowjanya Yarlagadda | 3336 Fairfield Ave Apt 304, Bridgeport, CT 06605-3288 | Physician/surgeon | 2018-05-01 ~ 2019-04-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Melissa Medina | 102 Clinton Ave., Bridgeport, CT 06605 | Medication Administration Certification | ~ |
| Maria Etelvina Lema | 20 Orland St, Bridgeport, CT 06605 | Nail Technician | ~ |
| Michelle Maldonado M�ndez | 182 Monroe St, Bridgeport, CT 06605 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Latavia Henderson | 178 Lewis Street, Bridgeport, CT 06605 | Medication Administration Certification | 2020-06-08 ~ 2022-06-07 |
| Onedu Nnenna Benson | 285 Laurel Avenue, Bridgeport, CT 06605 | Licensed Practical Nurse | ~ |
| Gregory A Korth | 137 Fayerweather Ter, Bridgeport, CT 06605 | Architect | 2020-08-01 ~ 2021-07-31 |
| Kim Anh Ho | 108 Wood Avenue, Bridgeport, CT 06605 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Maria-elena Melchor Mora | 653 Colorado Ave, Bridgeport, CT 06605 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Jennifer Nelson | 148 St Stephens Road, Bridgeport, CT 06605 | Esthetician | ~ |
| Santa Fuel Inc | 133 Admiral St, Bridgeport, CT 06605 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06605 | |||
| City | BRIDGEPORT |
| Zip Code | 06605 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + BRIDGEPORT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Priyadarshini Saride Venkata | 6210 Gibson Ln Apt 3202, Texarkana, TX 75503-1249 | Dentist | 2020-09-01 ~ 2021-08-31 |
| Priyadarshini Trikha Dds | 800 West St, Braintree, MA 02184 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Suresh S Balasubramanian | 8 Oakview Ln, Westport, CT 06880-4169 | Registered Nurse | 2012-08-01 ~ 2013-07-31 |
| Geetha Priyadarshini Krishnan | 9435 Ozark Ave, Morton Grove, IL 60053-1064 | Controlled Substance Registration for Practitioner | 2019-01-25 ~ 2021-02-28 |
| Ramya Balasubramanian | 110 Morning Glory Dr, Middletown, CT 06457-1778 | Engineer-in-training | ~ |
| Balasubramanian Shanmugam Md | 923 Farmington Ave, Bristol, CT 06010-3927 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Balasubramanian Venkataraman | 1058 Beechlawn Ter, Orange, CT 06477-1002 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Harinarayan Balasubramanian | 7 Austin Circle, So Windsor, CT 06074 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Balasubramanian Bhagavath | 101 Dudley Street, Providence, RI 02905 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Jin Woo Yoo | 44 Orange St Apt 317, New Haven, CT 06510 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
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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).