SAMIR C JETHWA (Credential# 1177015) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 2, 2013. The license expiration date date is December 31, 2014. The license status is INACTIVE.
SAMIR C JETHWA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.052573-DO. The credential type is physician/surgeon. The effective date is December 2, 2013. The expiration date is December 31, 2014. The business address is 629d Lowther Rd, Lewisberry, PA 17339-9222. The current status is inactive.
| Licensee Name | SAMIR C JETHWA |
| Credential ID | 1177015 |
| Credential Number | 1.052573-DO |
| Credential Type | Physician/Surgeon |
| Credential SubCategory | DO |
| Business Address |
629d Lowther Rd Lewisberry PA 17339-9222 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2013-12-02 |
| Effective Date | 2013-12-02 |
| Expiration Date | 2014-12-31 |
| Refresh Date | 2015-04-05 |
| Street Address | 629D LOWTHER RD |
| City | LEWISBERRY |
| State | PA |
| Zip Code | 17339-9222 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Neeti B. Goel | 629d Lowther Rd, Lewisberry, PA 17339-9222 | Physician/surgeon | 2018-10-01 ~ 2019-09-30 |
| Richard P Moser IIi | 629d Lowther Rd, Lewisberry, PA 17339-9222 | Physician/surgeon | 2016-10-01 ~ 2017-09-30 |
| Jonathan D. Stephenson | 629d Lowther Rd, Lewisberry, PA 17339-9222 | Physician/surgeon | 2016-08-01 ~ 2017-07-31 |
| Sarah H. Shipley | 629d Lowther Rd, Lewisberry, PA 17339-9222 | Physician/surgeon | 2016-05-01 ~ 2017-04-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kristin M Mcmahon | 760 Seitz Drive, Lewisberry, PA 17339 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Owen Patrick Mcmahon | 760 Seitz Drive, Lewsiberry, PA 17339 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Gastroparesis Patient Association for Cures and Treatments Inc. | Po Box 197, Lewisberry, PA 17339 | Public Charity-exempt From Financial Requirements | ~ |
| Douglas C Tilley | 1020 Silver Lake Rd, Lewisberry, PA 17339-9118 | Architect | ~ |
| Chad W Coeyman | 629 Lowther Rd # D, Lewisberry, PA 17339-9527 | Physician/surgeon | 2018-07-01 ~ 2019-06-30 |
| Zoetis Us LLC | 543 Industrial Dr Ste B, Lewisberry, PA 17339-9532 | Out of State Manufacturer of Drugs, Cosmetics & Medical Devices | 2013-07-23 ~ |
| City | LEWISBERRY |
| Zip Code | 17339 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + LEWISBERRY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Samir Gautam | 15 Barberry Ln, Woodbridge, CT 06525 | Physician/surgeon | 2019-07-01 ~ 2020-06-30 |
| Samir W Aziz | 40 Pleasant St, Ansonia, CT 06401 | Physician/surgeon | 2005-03-11 ~ 2006-03-31 |
| Samir G Artoul | C/o Med-dent Bsns, Clive, IA 50325 | Physician/surgeon | 2002-05-02 ~ 2003-02-28 |
| Samir A Fahmy | 58 Wildwood Terrace, Watchung, NJ 07069 | Physician/surgeon | 2016-01-01 ~ 2016-12-31 |
| Shady Samir Henien | 372 Benefit St Apt 1, Providence, RI 02903-2923 | Physician/surgeon | 2020-03-11 ~ 2020-10-31 |
| Samir Patel | 40 Prospect Ave, Apt 2f, Bldg. 1, Norwalk, CT 06850 | Physician/surgeon | 2002-08-16 ~ 2003-06-30 |
| Samir A Ahmad | 15724 Sambuca Circle, Austin, TX 78728 | Physician/surgeon | 1999-11-17 ~ 2001-01-31 |
| Samir Samarany | 6112 Town Walk Dr, Hamden, CT 06518 | Physician/surgeon | 2014-04-09 ~ 2014-09-30 |
| Samir Malkani Md | 109 Town Farm Road, Sutton, MA 01590 | Physician/surgeon | 2003-07-21 ~ 2004-08-31 |
| Samir G. Chaudhari Md | 375 Emerson Plz Unit 1212, Altamonte Springs, FL 32701-3479 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
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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).