AMANI A KOUDER
Resident Physician


Address: 8221 Avalon Gates, Trumbull, CT 06611-5830

AMANI A KOUDER (Credential# 2036305) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is June 22, 2020. The license expiration date date is June 30, 2024. The license status is ACTIVE.

Business Overview

AMANI A KOUDER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.065263-RES. The credential type is resident physician. The effective date is June 22, 2020. The expiration date is June 30, 2024. The business address is 8221 Avalon Gates, Trumbull, CT 06611-5830. The current status is active.

Basic Information

Licensee Name AMANI A KOUDER
Credential ID 2036305
Credential Number 1.065263-RES
Credential Type Resident Physician
Credential SubCategory RES
Business Address 8221 Avalon Gates
Trumbull
CT 06611-5830
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2020-06-22
Effective Date 2020-06-22
Expiration Date 2024-06-30
Refresh Date 2020-04-17

Other licenses

ID Credential Code Credential Type Issue Term Status
2054019 CSP.0074462 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2020-06-10 2020-06-10 - 2021-02-28 ACTIVE

Office Location

Street Address 8221 AVALON GATES
City TRUMBULL
State CT
Zip Code 06611-5830

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Ashley S Balestriere 7 Sutton Place, Trumbull, CT 06611 Registered Nurse 2020-08-01 ~ 2021-07-31
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Xuehuan Zhang 31 Asbury Rd, Trumbull, CT 06611 Combination Nail Technician, Esthetician Or Eyelash Technici ~
Antoinette D Senior 38 Tanager Lane, Trumbull, CT 06611 Registered Nurse 2020-07-01 ~ 2021-06-30
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Gary T Sorge 63 Limerick Road, Trumbull, CT 06611 Landscape Architect 2020-08-01 ~ 2021-07-31
Melodie T Noga 55 Moose Hill Road, Trumbull, CT 06611 Real Estate Salesperson 2020-06-19 ~ 2021-05-31
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Competitor

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City TRUMBULL
Zip Code 06611
License Type Resident Physician
License Type + County Resident Physician + TRUMBULL

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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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