SAMATHA K KADIYALA MD (Credential# 559684) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 23, 2009. The license expiration date date is June 30, 2010. The license status is INACTIVE.
SAMATHA K KADIYALA MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.042102. The credential type is physician/surgeon. The effective date is July 23, 2009. The expiration date is June 30, 2010. The business address is 615 Thoreau Circle, Windsor, CT 06095. The current status is inactive.
| Licensee Name | SAMATHA K KADIYALA MD |
| Credential ID | 559684 |
| Credential Number | 1.042102 |
| Credential Type | Physician/Surgeon |
| Business Address |
615 Thoreau Circle Windsor CT 06095 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2004-01-21 |
| Effective Date | 2009-07-23 |
| Expiration Date | 2010-06-30 |
| Refresh Date | 2010-10-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 363141 | CSP.0034579 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-03-07 - 2009-02-28 | INACTIVE |
| Street Address | 615 THOREAU CIRCLE |
| City | WINDSOR |
| State | CT |
| Zip Code | 06095 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cherene M Scott | 123 Clover St, Windsor, CT 06095 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Marianne Lauri | 9 Mohawk Circle, Windsor, CT 06095 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Elaine R Birthwright Rowe | 71 Ford Road, Windsor, CT 06095 | Real Estate Salesperson | ~ |
| Annmarie Blair-atkinson | 19 Hope Circle, Windsor, CT 06095 | Medication Administration Certification | 2020-05-23 ~ 2022-05-22 |
| Cristina Valente | 39 Lochview Dr, Windsor, CT 06095 | Master's Level Social Worker | 2020-07-01 ~ 2021-06-30 |
| Bridget C Tran | 500 Huckleberry Rd, Windsor, CT 06095 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Kelli Price | 15 Berrios Hill Road, Windsor, CT 06095 | Professional Counselor | 2020-09-01 ~ 2021-08-31 |
| Yalanda Squirewell | 217 Willowcrest Drive, Windsor, CT 06095 | Real Estate Salesperson | ~ |
| Omason O Modeste | 30 Lepage Rd, Windsor, CT 06095 | Emergency Medical Technician | 2017-04-06 ~ 2020-06-30 |
| Mark E Allen | 372 Broad St, Windsor, CT 06095 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06095 | |||
| City | WINDSOR |
| Zip Code | 06095 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + WINDSOR |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Samatha Bagam | 17513 89th Ave, Jamaica, NY 11432 | Physician/surgeon | 2008-09-23 ~ 2008-11-30 |
| Mamatha Kadiyala | 282 Kinne Road, Glastonbury, CT 06033 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Rajendra K Kadiyala | 622 W168th Street, New York, NY 10032 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Deepak Kadiyala | 240 South Marcliffe Dr Unit 7, Valparaiso, IN 46385 | Physician/surgeon | 2012-10-01 ~ 2013-09-30 |
| Samatha L Najman | 54 Wilson Rd, Wolcott, CT 06416 | Pharmacy Technician | 2020-04-01 ~ 2021-03-31 |
| Manjeera Kadiyala | 14015 Holly Ave Apt 4f, Flushing, NY 11355-3422 | Dentist | 2012-11-07 ~ 2013-11-30 |
| Samatha Kanumuru | 7 Walcott Green, South Windsor, CT 06074 | Pharmacy Technician | 2008-04-01 ~ 2009-03-31 |
| Vinay B Kadiyala | 53 Midbrook Ln, Old Greenwich, CT 06870-1432 | Emergency Medical Technician | 2009-10-22 ~ 2011-07-01 |
| Niveditha Kadiyala | 21 Beecher Lane, Rocky Hill, CT 06067-3148 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Tulasikrishna Kadiyala | 282 Kinne Road, Glastonbury, CT 06033 | Emergency Medical Technician | ~ |
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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).