AMANDA FANTRY
Physician/surgeon


Address: 1000 Asylum Ave, Hartford, CT 06105-1770

AMANDA FANTRY (Credential# 1504869) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2020. The license expiration date date is August 31, 2021. The license status is ACTIVE.

Business Overview

AMANDA FANTRY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.061342. The credential type is physician/surgeon. The effective date is September 1, 2020. The expiration date is August 31, 2021. The business address is 1000 Asylum Ave, Hartford, CT 06105-1770. The current status is active.

Basic Information

Licensee Name AMANDA FANTRY
Credential ID 1504869
Credential Number 1.061342
Credential Type Physician/Surgeon
Business Address 1000 Asylum Ave
Hartford
CT 06105-1770
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2018-06-08
Effective Date 2020-09-01
Expiration Date 2021-08-31
Refresh Date 2020-06-08

Other licenses

ID Credential Code Credential Type Issue Term Status
1523450 CSP.0068666 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2018-06-13 2019-03-01 - 2021-02-28 ACTIVE

Office Location

Street Address 1000 ASYLUM AVE
City HARTFORD
State CT
Zip Code 06105-1770

Licenses in the same location

Licensee Name Office Address Credential Effective / Expiration
Malta House of Care, Inc. · Malta House of Care Mobile Medicial Clinic 1000 Asylum Ave, Hartford, CT 06105-1770 Outpatient Clinic 2019-08-02 ~ 2022-06-30
Luis F Diez-morales 1000 Asylum Ave, Hartford, CT 06105 Physician/surgeon 2020-07-01 ~ 2021-06-30
H Robert Silverstein 1000 Asylum Ave, Hartford, CT 06105-1794 Physician/surgeon 2020-06-01 ~ 2021-05-31
Peter P White 1000 Asylum Ave, Hartford, CT 06105 Physician/surgeon 2020-04-01 ~ 2021-03-31
Bechara Barrak Md 1000 Asylum Ave, Hartford, CT 06105 Physician/surgeon 2020-04-01 ~ 2021-03-31
Malta House of Care, Inc.-st. Peter's Church 1000 Asylum Ave, Hartford, CT 06105-1770 Outpatient Clinic 2017-04-01 ~ 2021-03-31
Martin Hoffman Do 1000 Asylum Ave, Hartford, CT 06105 Physician/surgeon 2020-03-01 ~ 2021-02-28
Eugene D Sullivan 1000 Asylum Ave, Hartford, CT 06105 Physician/surgeon 2020-03-01 ~ 2021-02-28
James M Feeney Md · A Proof of Concept, Open Label Prospective Pilot Study of Cannabis Use In Trauma Patients With Multiple Rib Fractures. 1000 Asylum Ave, Hartford, CT 06105-1770 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Aileen Pangilinan 1000 Asylum Ave, Hartford, CT 06105 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Find all Licenses in the same address

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Vincent M Varilla 1000 Asylum Ave Ste 1025, Hartford, CT 06105-1770 Physician/surgeon 2020-06-01 ~ 2021-05-31

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Hartford Community Loan Fund 215 Garden Street, Hartford, CT 06105 Public Charity 2019-06-01 ~ 2020-05-31
Kathleen C Hobart 81 Fern Street, Hartford, CT 06105 Registered Nurse 2020-07-01 ~ 2021-06-30
Khadija Seidi 196 Laurel St, Hartford, CT 06105 Licensed Practical Nurse 2020-07-01 ~ 2021-06-30
Stuart W Alpert 200 N Beacon St, Hartford, CT 06105 Licensed Clinical Social Worker 2020-09-01 ~ 2021-08-31
Christina Perez 4 Atwood Street, Hartford, CT 06105 Marital and Family Therapist 2020-07-01 ~ 2021-06-30
Ashley Ameena Bachan 25 Owen Street, Hartford, CT 06105 Licensed Practical Nurse 2020-06-01 ~ 2021-05-31
Dhruti Anilkant Mankodi Hospitalist Department, Hartford, CT 06105 Physician/surgeon 2020-08-01 ~ 2021-07-31
Jacqueline Alexandra Raymond 24 Owen Street, Hartford, CT 06105 Esthetician 2020-06-22 ~ 2021-10-31
Hortense Bates 48-50 Atwood Street, Hartford, CT 06105 Medication Administration Certification 2020-08-20 ~ 2022-08-19
Nicolas Archambault 169 Sigourney Street, Hartford, CT 06105 Emergency Medical Technician ~
Find all Licenses in zip 06105

Competitor

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City HARTFORD
Zip Code 06105
License Type Physician/Surgeon
License Type + County Physician/Surgeon + HARTFORD

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Dataset Information

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).

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