MUKTA C SRIVASTAVA MD (Credential# 562946) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 28, 2008. The license expiration date date is March 31, 2009. The license status is INACTIVE.
MUKTA C SRIVASTAVA MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.045364. The credential type is physician/surgeon. The effective date is January 28, 2008. The expiration date is March 31, 2009. The business address is 123 York St #3c, New Haven, CT 06511. The current status is inactive.
| Licensee Name | MUKTA C SRIVASTAVA MD |
| Credential ID | 562946 |
| Credential Number | 1.045364 |
| Credential Type | Physician/Surgeon |
| Business Address |
123 York St #3c New Haven CT 06511 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2007-05-07 |
| Effective Date | 2008-01-28 |
| Expiration Date | 2009-03-31 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 381054 | CSP.0036298 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2004-10-05 | 2008-03-01 - 2009-02-28 | INACTIVE |
| Street Address | 123 YORK ST #3C |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Montessori School On Edgewood Inc. | 230 Edgewood Avenue, New Haven, CT 06511 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Therese Parks · Visel Drug Store | 264 Munson St, New Haven, CT 06511 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dazjia Monet Green | 115 Edgewood Ave Apt 64, New Haven, CT 06511 | Registered Nurse | 2020-06-27 ~ 2021-05-31 |
| Carol Yam | 343 Humphrey St, New Haven, CT 06511 | Registered Nurse | ~ |
| Marwan S Haddad | 38 Lincoln Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mary Lou Gaeta Md | 558 Chapel Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Cary M Tucker | 64 Bishop St, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Frank J Pannenborg | 505 Ellsworth Ave, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Crystal E Gooding | 26 Woodland Street, New Haven, CT 06511 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Kieran Jones | 260 Crown St Unit 1f, New Haven, CT 06511 | Registered Nurse | ~ |
| Find all Licenses in zip 06511 | |||
| City | NEW HAVEN |
| Zip Code | 06511 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mukta S Sharma | 31 Hickory Ln, Bedford, NY 10506-1533 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Mukta Dhond | 950 Campbell Avenue, West Haven, CT 06516 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Bal K Srivastava | 223 Piedmont Avenue, Cincinnati, OH 45219 | Physician/surgeon | ~ 1997-07-31 |
| Bhaskar Srivastava | 12 Academy St Apt 2a, New Haven, CT 06511-6973 | Physician/surgeon | 2016-04-01 ~ 2017-03-31 |
| Ajay V Srivastava Md | 597 Westport Avenue, Apt A 302, Norwalk, CT 06851 | Physician/surgeon | 2012-04-01 ~ 2013-03-31 |
| Neeraj Srivastava | 6802 Ridge Blvd, Brookyln, NY 11220 | Physician/surgeon | 2008-08-01 ~ 2009-08-31 |
| Sangeeta Srivastava | 6421 Clough Pike, Cincinnati, OH 45244 | Physician/surgeon | 1997-06-11 ~ 1998-05-31 |
| Abhishek Srivastava | 15 Top St, Westerly, RI 02891-1905 | Pharmacist | 2018-02-01 ~ 2020-01-31 |
| Maya Srivastava | 210 Silver Spring Rd, Wilton, CT 06897-1021 | Emergency Medical Technician | 2012-03-13 ~ 2014-07-01 |
| Neil C. Srivastava Md | 8 Penelope Dr, Setauket, NY 11733-2010 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).