YESU KUMAR MATTA (Credential# 1790750) is licensed (Physician/surgeon) 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 ACTIVE.
YESU KUMAR MATTA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.064545. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 54 Borden Ave Apt A16, Norwich, NY 13815-1176. The current status is active.
Licensee Name | YESU KUMAR MATTA |
Credential ID | 1790750 |
Credential Number | 1.064545 |
Credential Type | Physician/Surgeon |
Business Address |
54 Borden Ave Apt A16 Norwich NY 13815-1176 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2019-11-04 |
Effective Date | 2020-07-01 |
Expiration Date | 2021-06-30 |
Refresh Date | 2020-06-23 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1997585 | CSP.0073003 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2020-01-09 | 2020-01-09 - 2021-02-28 | ACTIVE |
Street Address | 54 BORDEN AVE APT A16 |
City | NORWICH |
State | NY |
Zip Code | 13815-1176 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Professional Teleconcepts, LLC | 5132 State Highway 12 South, Norwich, NY 13815 | Major Contractor | 2020-07-01 ~ 2021-06-30 |
David R Crain | Rd#3, Box 133b, Norwich, NY 13815 | Crane Operator | 1992-03-01 ~ 1994-02-28 |
Grover L Simpson | Hc 67, Box 358 A, Norwich, NY 13815 | Crane Operator | 1994-11-17 ~ 1996-11-16 |
Kristin E Nassar | 182 Sharman Dr, Norwich, NY 13815 | Engineer-in-training | 2006-11-14 ~ 2016-11-14 |
Professional Teleconcepts Inc | 5132 State Highway 12, Norwich, NY 13815 | Major Contractor | 2015-04-01 ~ 2016-06-30 |
Tom Shelito · Qc-2 | 67 Rexford St, Norwich, NY 13815 | Electrical Limited Journeyperson | ~ |
Lynn P Banocy · Mastrogiovanni | 118 Dan Main Hill Road, Norwich, NY 13815 | Licensed Practical Nurse | 2012-01-01 ~ 2012-12-31 |
Emily M Manwarren | 130 Dan Main Hill, Norwich, NY 13815 | Licensed Practical Nurse | 2006-11-15 ~ 2007-08-31 |
Peter J Kasmarcik | 7 Brown Ave, Norwich, NY 13815 | Electrical Limited Journeyperson | 2002-10-21 ~ 2003-09-30 |
Joanne Marino-dann | P.o. Box 341, Norwich, NY 13815 | Licensed Practical Nurse | 2006-02-16 ~ 2007-01-31 |
Find all Licenses in zip 13815 |
City | NORWICH |
Zip Code | 13815 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + NORWICH |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Ayman Z Matta | 99 Dutch Hill Rd, Orangeburg, NY 10962-2185 | Physician/surgeon | ~ |
Stephen Matta | 3956 Terrace St, Philadelphia, PA 19128-5227 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
Arvind Kumar | CT | Physician/surgeon | 1988-05-27 ~ 1988-12-31 |
Anil Kumar Mongia | 381 Elm Dr, Roslyn, NY 11576-3045 | Physician/surgeon | ~ |
Swarup Kumar | 24 Park Pl Apt 9f, Hartford, CT 06106-5022 | Physician/surgeon | ~ |
Sandeep Kumar | 300 Woodcliff Rd, Newton, MA 02461-2128 | Physician/surgeon | ~ |
Kumar S Kalapatapu | Chappaqua, NY 10514 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
Alok Kumar | 759 Chestnut St, Springfield, MA 01199-1001 | Physician/surgeon | ~ |
Manjula Kumar | 913 W. Lockhart St, Sayre, PA 18840 | Physician/surgeon | 1996-12-19 ~ 1997-10-31 |
Chandrika Kumar | 20 York St, New Haven, CT 06510-3220 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
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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).