ANISHA MANDAVA (Credential# 564681) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2009. The license expiration date date is June 30, 2010. The license status is INACTIVE.
ANISHA MANDAVA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.047099. The credential type is physician/surgeon. The effective date is June 1, 2009. The expiration date is June 30, 2010. The business address is University of Connecticut, Farmington, CT 06030. The current status is inactive.
Licensee Name | ANISHA MANDAVA |
Credential ID | 564681 |
Credential Number | 1.047099 |
Credential Type | Physician/Surgeon |
Business Address |
University of Connecticut Farmington CT 06030 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 2008-10-20 |
Effective Date | 2009-06-01 |
Expiration Date | 2010-06-30 |
Refresh Date | 2010-10-06 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1042583 | CSP.0051726 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | - | EXPIRED APPLICATION |
Street Address | UNIVERSITY OF CONNECTICUT |
City | FARMINGTON |
State | CT |
Zip Code | 06030 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Jennifer M Wolf Md | University of Connecticut, Farmington, CT 06030-0001 | Physician/surgeon | 2016-07-01 ~ 2017-06-30 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
Find all Licenses in zip 06030 |
City | FARMINGTON |
Zip Code | 06030 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + FARMINGTON |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Anisha Mandava Md | 2 Park Pl Apt 11d, Hartford, CT 06106-5012 | Controlled Substance Registration for Practitioner | 2009-06-30 ~ 2011-02-28 |
Suresh Mandava | 2046 W. Main St. Ste 2, Stamford, CT 06902 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Anisha A Jangi Md | 69 Sand Pit Rd Ste 101, Danbury, CT 06810-4004 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Anisha D Patel Md | 966 Green Cir, Orange, CT 06477-1736 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Sobha Mandava Cpa PC | 10 Muirfield Blvd, Monroe Township, NJ 08831 | Certified Public Accountant Firm Permit | 2004-01-01 ~ 2004-12-31 |
Anisha Mistry | 111 Ledgewood Rd Apt 303, Groton, CT 06340-6603 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
Anisha Garg | 20 York Street, New Haven, CT 06510 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
Anitha Rao Mandava | 174 Providence Ln., Lansdale, PA 19446 | Pharmacist | 2012-02-14 ~ 2014-01-31 |
Ratnakar R Mandava Dds | 95 Higgins Rd, Cheshire, CT 06410 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Sobha R Mandava | 10 Muirfield Blvd, Monroe Township, NJ 08831 | Certified Public Accountant License | 2004-01-01 ~ 2004-12-31 |
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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).