SELVAM J MASCARENHAS
Physician/surgeon


Address: 40 Prospect St, Bldg 1 Apt 3e, Norwalk, CT 06850

SELVAM J MASCARENHAS (Credential# 562065) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 20, 2006. The license expiration date date is May 31, 2007. The license status is INACTIVE.

Business Overview

SELVAM J MASCARENHAS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.044483. The credential type is physician/surgeon. The effective date is June 20, 2006. The expiration date is May 31, 2007. The business address is 40 Prospect St, Bldg 1 Apt 3e, Norwalk, CT 06850. The current status is inactive.

Basic Information

Licensee Name SELVAM J MASCARENHAS
Credential ID 562065
Credential Number 1.044483
Credential Type Physician/Surgeon
Business Address 40 Prospect St, Bldg 1 Apt 3e
Norwalk
CT 06850
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2006-06-20
Effective Date 2006-06-20
Expiration Date 2007-05-31
Refresh Date 2009-07-08

Office Location

Street Address 40 Prospect St, Bldg 1 Apt 3E
City Norwalk
State CT
Zip Code 06850

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Vincent Grasso 21 Rae Lane, Norwalk, CT 06850 Architect 2020-08-01 ~ 2021-07-31
Karen G Nicolas 16 Orange St, Norwalk, CT 06850 Registered Nurse 2020-09-01 ~ 2021-08-31
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Competitor

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City Norwalk
Zip Code 06850
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Norwalk

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Kalai Selvam Sivarajan 29 Baggott St, West Haven, CT 06516-2804 Emergency Medical Technician 2011-07-12 ~ 2013-07-01
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Kristy Mascarenhas Md 38 Fairview Dr, Farmington, CT 06032-2541 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Fabiane G Mascarenhas · Minas Corner 29 Federal St, Bridgeport, CT 06606 Restaurant Wine & Beer 2013-02-13 ~ 2014-02-12
Russell H Harris Md Envision Physician Services, Horsham, PA 19044 Physician/surgeon 2019-09-01 ~ 2020-08-31
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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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