PAVAN MANCHIKALAPATI MD (Credential# 560935) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 18, 2006. The license expiration date date is July 31, 2007. The license status is INACTIVE.
PAVAN MANCHIKALAPATI MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.043353. The credential type is physician/surgeon. The effective date is May 18, 2006. The expiration date is July 31, 2007. The business address is 2600 Vaughn Lakes Blvd#835, Montgomery, AL 36117. The current status is inactive.
| Licensee Name | PAVAN MANCHIKALAPATI MD |
| Credential ID | 560935 |
| Credential Number | 1.043353 |
| Credential Type | Physician/Surgeon |
| Business Address |
2600 Vaughn Lakes Blvd#835 Montgomery AL 36117 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2005-04-25 |
| Effective Date | 2006-05-18 |
| Expiration Date | 2007-07-31 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 405427 | CSP.0037510 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-05-20 | 2006-03-01 - 2007-02-28 | INACTIVE |
| Street Address | 2600 VAUGHN LAKES BLVD#835 |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36117 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patricia Burbank | 6721 Post Oak Lane, Montgomery, AL 36117 | Physical Therapist | 2017-10-01 ~ 2018-09-30 |
| George Witt | 136 Creek Drive, Montgomery, AL 36117 | Psychologist | 1998-08-18 ~ 1999-10-31 |
| David E Lipton | 422 Seminole Dr, Montgomery, AL 36117 | Physician/surgeon | 1993-04-23 ~ 1994-06-30 |
| Donald L Thompson | 7248 Waters Edge, Montgomery, AL 36117 | Psychologist | 2001-08-20 ~ 2002-08-31 |
| Virginia L Alldredge | 6909 Fox Creek Ct, Montgomery, AL 36117 | Physical Therapist | ~ 1996-07-31 |
| Deborah R Stovall | 513 Dunbarton Road, Montgomery, AL 36117 | Registered Nurse | 1996-06-25 ~ 1997-06-30 |
| Barbara E Deloney | 6049 Camelot Court, Montgomery, AL 36117 | Registered Nurse | 1994-04-07 ~ 1995-06-30 |
| Taunya F Hoffman | 6308 Sequoia Drive, Montgomery, AL 36117 | Registered Nurse | ~ 1996-12-31 |
| Jennifer L Guthrie | 1850 Brookstone Drive, Montgomery, AL 36117 | Registered Nurse | 2004-08-16 ~ 2005-10-31 |
| Allen R. Foster | 8001 Lakeridge Dr, Montgomery, AL 36117-5141 | Physician/surgeon | 1998-09-30 ~ 1999-11-30 |
| Find all Licenses in zip 36117 | |||
| City | MONTGOMERY |
| Zip Code | 36117 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + MONTGOMERY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Pavan Kumar Punukollu | 20 Charlotte Drive, Andover, MA 01810 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Pavan Liqueur | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2017-03-20 ~ 2020-03-19 |
| Pavan K Challa | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-06-10 ~ 2022-06-21 |
| Pavan Ganapathiraju | 3527 Windsor Ct, Mays Landing, NJ 08330-3210 | Resident Physician | 2019-07-01 ~ 2021-06-30 |
| Pavan Liqueur De France | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2014-02-19 ~ 2017-02-18 |
| Aldo Pavan | 354 Keeney St, Manchester, CT 06040 | Electrical Unlimited Contractor | 2004-10-01 ~ 2005-09-30 |
| Pavan Kumar Alapati | 405 Hollyhill Drive, Rockyhill, CT 06067 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Pavan Kumar Kanikicherla | 149 Old Country Rd, Deer Park, NY 11729-1920 | Engineer-in-training | 2018-04-16 ~ 2028-04-16 |
| Louis Pavan | 92 Brookside Rd., Waterbury, CT 06708 | Medication Administration Certification | 2000-12-13 ~ 2002-12-12 |
| Pavan Jain | 56 Franklin St, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
Please comment or provide details below to improve the information on PAVAN MANCHIKALAPATI MD.
| 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).