SRINIVAS R. MANDALA DDS
Dentist


Address: 611 Madison Place, Shrewsbury, MA 01545

SRINIVAS R. MANDALA DDS (Credential# 935838) is licensed (Dentist) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2016. The license expiration date date is May 31, 2017. The license status is INACTIVE.

Business Overview

SRINIVAS R. MANDALA DDS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #2.010274. The credential type is dentist. The effective date is June 1, 2016. The expiration date is May 31, 2017. The business address is 611 Madison Place, Shrewsbury, MA 01545. The current status is inactive.

Basic Information

Licensee Name SRINIVAS R. MANDALA DDS
Credential ID 935838
Credential Number 2.010274
Credential Type Dentist
Business Address 611 Madison Place
Shrewsbury
MA 01545
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2010-06-21
Effective Date 2016-06-01
Expiration Date 2017-05-31
Refresh Date 2017-09-03

Other licenses

ID Credential Code Credential Type Issue Term Status
937908 CSP.0047866 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2010-07-01 2015-03-01 - 2017-02-28 INACTIVE

Office Location

Street Address 611 MADISON PLACE
City SHREWSBURY
State MA
Zip Code 01545

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Competitor

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City SHREWSBURY
Zip Code 01545
License Type Dentist
License Type + County Dentist + SHREWSBURY

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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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