ASHIF K JETHAVA MD
Controlled Substance Registration for Practitioner


Address: 76 Steeplechase Dr, Newington, CT 06111-5703

ASHIF K JETHAVA MD (Credential# 977111) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is July 2, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.

Business Overview

ASHIF K JETHAVA MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0049423. The credential type is controlled substance registration for practitioner. The effective date is July 2, 2015. The expiration date is February 28, 2017. The business address is 76 Steeplechase Dr, Newington, CT 06111-5703. The current status is inactive.

Basic Information

Licensee Name ASHIF K JETHAVA MD
Credential ID 977111
Credential Number CSP.0049423
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 76 Steeplechase Dr
Newington
CT 06111-5703
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2010-12-16
Effective Date 2015-07-02
Expiration Date 2017-02-28
Refresh Date 2018-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
971666 1.049340 Physician/Surgeon 2010-11-09 2015-03-01 - 2016-02-29 INACTIVE

Office Location

Street Address 76 STEEPLECHASE DR
City NEWINGTON
State CT
Zip Code 06111-5703

Licenses in the same location

Licensee Name Office Address Credential Effective / Expiration
Nazneen Jethava 76 Steeplechase Dr, Newington, CT 06111-5703 Registered Nurse 2016-08-01 ~ 2017-07-31

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Melissa D Persaud 80 Steeplechase Dr, Newington, CT 06111-5703 Psychologist 2020-05-01 ~ 2021-04-30
Colin Matthew Kush 74 Steeplechase Dr, Newington, CT 06111-5703 Licensed Clinical Social Worker 2020-04-01 ~ 2021-03-31

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Anastasya Anisimova 114 Fox Run Court, Newington, CT 06111 Registered Nurse 2020-08-01 ~ 2021-07-31
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Shandea Edwards 21 Hartford Ave #14, Newington, CT 06111 Medication Administration Certification ~
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Competitor

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City NEWINGTON
Zip Code 06111
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEWINGTON

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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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