SHRUTI P MUTALIK (Credential# 1117933) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is February 25, 2014. The license expiration date date is December 31, 2014. The license status is INACTIVE.
SHRUTI P MUTALIK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.051415. The credential type is physician/surgeon. The effective date is February 25, 2014. The expiration date is December 31, 2014. The business address is 3775 63rd St Apt B39, Woodside, NY 11377-2664. The current status is inactive.
| Licensee Name | SHRUTI P MUTALIK |
| Credential ID | 1117933 |
| Credential Number | 1.051415 |
| Credential Type | Physician/Surgeon |
| Business Address |
3775 63rd St Apt B39 Woodside NY 11377-2664 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2012-09-24 |
| Effective Date | 2014-02-25 |
| Expiration Date | 2014-12-31 |
| Refresh Date | 2015-04-05 |
| Street Address | 3775 63RD ST APT B39 |
| City | WOODSIDE |
| State | NY |
| Zip Code | 11377-2664 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Yeo Jung Cho | 45-52 47th Street, Woodside, NY 11377 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Kihyun Kim | 37-76 62st, Woodside, NY 11377 | Nail Technician | ~ |
| Bokyoung Kim | 3776 62nd St, Woodside, NY 11377 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Heejung Lee | 4039 62nd St 3fl, Woodside, NY 11377 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Yong Ye Kim | 48-24 66th St Fl 2, Woodside, NY 11377 | Nail Technician | 2020-06-17 ~ 2021-10-31 |
| Irene Pauline P Ilagan | 4413 65th Street, Woodside, NY 11377 | Physical Therapist | 2020-07-01 ~ 2021-06-30 |
| Pui Sing Yee | 47-18 45th Street 2nd Floor, Woodside, NY 11377 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Zalak Patel | 3982 65pl, Woodside, NY 11377 | Physician/surgeon | 2019-08-28 ~ 2019-11-30 |
| Elena Tello | 45-35 46th Street, Woodside, NY 11377 | Registered Nurse - Temporary | 2019-10-25 ~ 2020-02-22 |
| Dominique A Elie | 54-17 31st Avenue Apt 6m, Woodside, NY 11377 | Master's Level Social Worker | 2020-03-01 ~ 2021-02-28 |
| Find all Licenses in zip 11377 | |||
| City | WOODSIDE |
| Zip Code | 11377 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + WOODSIDE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Shruti Kumar | 44 Uplands Way, Glastonbury, CT 06033-3357 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Shruti Deopujari | 330 W Brambleton Avenue, Norfolk, VA 23510 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Shruti A Shukla | 8003 Inverness Lakes Trl, Fort Wayne, IN 46804-3845 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Sunil S Mutalik | 88 Brittany Farms Road, New Britain, CT 06053 | Resident Dentist | 2016-07-01 ~ 2019-06-30 |
| Shruti Poojary | 163 Columbia Ave # 2, Jersey City, NJ 07307-4020 | Physical Therapist | 2017-08-23 ~ 2018-06-30 |
| Shruti Tandon | 1613 Gates Ct, Morris Plains, NJ 07950-3467 | Dentist | 2015-07-01 ~ 2016-07-31 |
| Shruti R Shinde | 1311 Claro Dr, Manchester, CT 06042-7317 | Physical Therapist | 2019-11-01 ~ 2020-10-31 |
| Shruti R Shinde | 2306 W Taylor St Apt #1, Chicago, IL 60612 | Physical Therapist Assistant | ~ |
| Shruti Joshi | 50 Saw Mill Road Unit 3215, Danbury, CT 06810 | Professional Counselor | 2019-06-01 ~ 2020-05-31 |
| Shruti Gupta Md | 49 Treadwell Avenue, Westport, CT 06880 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on SHRUTI P MUTALIK.
| 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).