KISHANRAO BOGAVELLI
Physician/surgeon


Address: 29 Culvert Street, Portjervis, NY 12771

KISHANRAO BOGAVELLI (Credential# 546744) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2010. The license expiration date date is August 31, 2011. The license status is INACTIVE.

Business Overview

KISHANRAO BOGAVELLI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.027725. The credential type is physician/surgeon. The effective date is September 1, 2010. The expiration date is August 31, 2011. The business address is 29 Culvert Street, Portjervis, NY 12771. The current status is inactive.

Basic Information

Licensee Name KISHANRAO BOGAVELLI
Credential ID 546744
Credential Number 1.027725
Credential Type Physician/Surgeon
Business Address 29 Culvert Street
Portjervis
NY 12771
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1986-10-16
Effective Date 2010-09-01
Expiration Date 2011-08-31
Refresh Date 2011-12-02

Office Location

Street Address 29 Culvert Street
City Portjervis
State NY
Zip Code 12771

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Jeanette Collazo 569 Old Mountain Road, Port Jervis, NY 12771 Registered Nurse 2019-11-01 ~ 2020-10-31
Alexander Quick 6 Lyman Ave, Port Jervis, NY 12771 Repairer of Weighing & Measuring Devices 2015-02-26 ~ 2015-12-31
Robert E Habig 20 Kingston Ave, Port Jervis, NY 12771 Architect 1999-08-01 ~ 2000-07-31
Derek L Somerville 25 Buckley Street, Port Jervis, NY 12771 Occupational Therapist Assistant 2008-05-23 ~ 2009-07-31
William P Kowal 4 Court Helaine, Port Jenis, NY 12771 Occupational Therapist Assistant ~ 1995-07-31
Meghann A Collins 37 Sussex Street, Port Jervis, NY 12771 Professional Counselor 2007-04-20 ~ 2008-05-31
Kim J Decker 39 Church St #29, Port Jervis, NY 12771 Registered Nurse 1993-02-25 ~ 1993-09-30
Marcolino M Andalis 721 Minisimk Tpke, Port Jervis, NY 12771 Respiratory Care Practitioner 2002-12-02 ~ 2004-01-31
Janice S Mortenson Town of Greenville, Port Jervis, NY 12771 Registered Nurse 2006-09-18 ~ 2007-08-31
Katherine C Moshinski · Empire Hm Mdrnztn Inc (s) 132 Ball St, Port Jervis, NY 12771 Home Improvement Salesperson ~ 1994-01-01
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Competitor

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City Portjervis
Zip Code 12771
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Portjervis

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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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