ANDREA V OTERO LUNA (Credential# 1490884) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2017. The license expiration date date is June 30, 2021. The license status is ACTIVE.
ANDREA V OTERO LUNA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.058986-RES. The credential type is resident physician. The effective date is July 1, 2017. The expiration date is June 30, 2021. The business address is 217 Pine St Apt 10, Danville, PA 17821-1989. The current status is active.
| Licensee Name | ANDREA V OTERO LUNA |
| Credential ID | 1490884 |
| Credential Number | 1.058986-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
217 Pine St Apt 10 Danville PA 17821-1989 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-07-01 |
| Effective Date | 2017-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-05-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1417340 | CSP.0065188 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-06-12 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 217 PINE ST APT 10 |
| City | DANVILLE |
| State | PA |
| Zip Code | 17821-1989 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jaya Prakash Prakash Sugunaraj | 75 Abbey Road, Danville, PA 17821 | Physician/surgeon | 2019-07-01 ~ 2020-06-30 |
| Diane L Carrier | 120 Palmer Drive, Danville, PA 17821 | Registered Nurse | 2019-08-01 ~ 2020-07-31 |
| Martin Michael Beninsky | 19 East Market St, Danville, PA 17821 | Registered Nurse | 2017-10-06 ~ 2018-10-31 |
| Stuart N Hoffman | 19 Magnolia Drive, Danville, PA 17821 | Physician/surgeon | 2016-10-01 ~ 2017-09-30 |
| Atarad N Shirani | 11 Edgewood Dr, Danville, PA 17821 | Real Estate Salesperson | 2010-08-02 ~ 2011-05-31 |
| Melanie Joy Cunningham Aprn | 215 Kelly's Dam Rd, Danville, PA 17821 | Controlled Substance Registration for Practitioner | 2011-11-17 ~ 2013-02-28 |
| Carol Ann Pearson | Rd 2 Box 11, Danville, PA 17821 | Registered Nurse | 1982-08-31 ~ 1985-06-30 |
| Manivel Eswaran | E-1 Mahoning Terrace, Danville, PA 17821 | Physician/surgeon | 2011-06-01 ~ 2012-05-31 |
| Austine Mengnjo Md | 12 Nicholas Avenue, Danville, PA 17821 | Physician/surgeon | 2010-10-01 ~ 2011-09-30 |
| William F Pharr | 186 Diehl Rd, Danville, PA 17821 | Physician/surgeon | 1997-07-31 ~ 1998-07-31 |
| Find all Licenses in zip 17821 | |||
| City | DANVILLE |
| Zip Code | 17821 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + DANVILLE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrea H Russo | 51-53 Kenosia Ave, Danbury, CT 06810-2304 | Resident Physician | 2015-05-18 ~ 2021-06-30 |
| Andrea Elizabeth Roberts | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Andrea Christina Farela | 20 York St, New Haven, CT 06510 | Resident Physician | 2020-08-01 ~ 2021-06-30 |
| Andrea Para Lincoln | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-06-24 ~ 2021-08-31 |
| Andrea Rachel Marcadis | 20 York Street, New Haven, CT 06510 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Andrea Rodriguez | 2800 Main Street, 3rd Floor Med Ed, Bridgeport, CT 06606 | Resident Physician | 2017-07-01 ~ 2020-06-30 |
| Luna Di Luna Red | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2005-10-20 ~ 2008-10-19 |
| Andrea M Montilla-santiago | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2018-06-28 ~ 2022-06-30 |
| Luna Di Luna Progrigio | Ct Brand Registration, Hartford, CT 06103 | Liquor Brand Label | 2017-04-26 ~ 2020-04-25 |
| Luna Di Luna Chardonnay Sauvignon | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2007-10-10 ~ 2010-10-09 |
Please comment or provide details below to improve the information on ANDREA V OTERO LUNA.
| 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).