SHANTANU SRINIVASAN KIDAMBI (Credential# 565105) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
SHANTANU SRINIVASAN KIDAMBI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.047523. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 82 Lakeside Ave, Webster, MA 01570-1568. The current status is active.
Licensee Name | SHANTANU SRINIVASAN KIDAMBI |
Credential ID | 565105 |
Credential Number | 1.047523 |
Credential Type | Physician/Surgeon |
Business Address |
82 Lakeside Ave Webster MA 01570-1568 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2009-04-01 |
Effective Date | 2020-05-01 |
Expiration Date | 2021-04-30 |
Refresh Date | 2020-02-14 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
530162 | CSP.0045379 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-04-17 | 2019-03-12 - 2021-02-28 | ACTIVE |
Street Address | 82 lakeside ave |
City | WEBSTER |
State | MA |
Zip Code | 01570-1568 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Robert L Goulet | 13 Asselin Ave., Webster, MA 01570 | Crane Operator | 2018-05-12 ~ 2020-05-11 |
Cam's Oil Service Inc | 3 Old Worcester Road, Webster, MA 01570 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Amy Michelle Williams | 327 Thompson Rd., Webster, MA 01570 | Registered Nurse | ~ |
Lillian Le | 1 Brianna Dr, Webster, MA 01570 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-05-28 ~ 2021-06-30 |
Elaine M Ziemba | 18 Stoughton Ave, Webster, MA 01570 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Robert L Mason | P.o. Box 791, Webster, MA 01570 | Sub-surface Sewage Installer | 2020-07-01 ~ 2021-06-30 |
Sally M Ceppetelli · Lomme | 8 B Deerfield Dr West, Webster, MA 01570 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
Robin J Korch | 808 Beacon Park, Webster, MA 01570 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
Patricia A Mclaughlin | 31 Third St, Webster, MA 01570 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Crystal Leigh Simonson | 304 Treasure Island Road, Webster, MA 01570 | Notary Public Appointment | 2015-04-02 ~ 2020-04-30 |
Find all Licenses in zip 01570 |
City | WEBSTER |
Zip Code | 01570 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + WEBSTER |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Srinivasan Paramasivam | 515 W 59th St Apt 4a, New York, NY 10019-1034 | Physician/surgeon | ~ |
Krithika Srinivasan | 38 Crown St, New Haven, CT 06510 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
Anand Srinivasan | 43 Cedar Lane, Closter, NJ 07624 | Physician/surgeon | 2001-03-12 ~ 2001-10-31 |
Ashmitha Srinivasan | 27 James P Kelly Way, Middletown, NY 10940 | Physician/surgeon | 2012-10-01 ~ 2013-09-30 |
Sriraman Ram Srinivasan | 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Shankar Srinivasan Md | 4121 Town Walk Dr, Hamden, CT 06518 | Physician/surgeon | 2007-08-16 ~ 2008-06-30 |
Melukote K Srinivasan | Salem Radiology, Salem, NH 03079 | Physician/surgeon | 2010-03-01 ~ 2011-02-28 |
Shantanu Lal | 160 Riverside Blvd, New York, NY 10069 | Dentist | ~ |
Vaman B Kidambi | 444 Bedford Street Apt 2 H, Stamford, CT 06901 | Notary Public Appointment | 2001-12-19 ~ 2006-12-31 |
Ramanatha Srinivasan | 1815 Rte 313, Perkasie, PA 18944 | Veterinarian | 1993-01-25 ~ 1993-09-30 |
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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).