PREM NATH
Physician/surgeon


Address: 12 John Calvin St, Blauvelt, NY 10913

PREM NATH (Credential# 553504) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 5, 2009. The license expiration date date is January 19, 2010. The license status is INACTIVE.

Business Overview

PREM NATH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.035911. The credential type is physician/surgeon. The effective date is May 5, 2009. The expiration date is January 19, 2010. The business address is 12 John Calvin St, Blauvelt, NY 10913. The current status is inactive.

Basic Information

Licensee Name PREM NATH
Credential ID 553504
Credential Number 1.035911
Credential Type Physician/Surgeon
Business Address 12 John Calvin St
Blauvelt
NY 10913
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1997-04-04
Effective Date 2009-05-05
Expiration Date 2010-01-19
Refresh Date 2019-11-22

Other licenses

ID Credential Code Credential Type Issue Term Status
211855 CSP.0028113 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2000-05-18 - 2001-02-28 INACTIVE

Office Location

Street Address 12 John Calvin St
City Blauvelt
State NY
Zip Code 10913

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Andean Brewing Company Inc · Andrean Brewing Company 300 Corporate Dr Ste 2, Blauvelt, 10913 Out of State Shipper Beer 2014-01-10 ~ 2015-01-09
Manoog A Egazarian 5 Ashwood Dr, Blauvelt, NY 10913 Professional Engineer 1991-01-23 ~ 1993-01-31
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City Blauvelt
Zip Code 10913
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Blauvelt

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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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