MALAVIKA BANDARI (Credential# 1266512) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2019. The license expiration date date is August 31, 2020. The license status is ACTIVE.
MALAVIKA BANDARI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.054259. The credential type is physician/surgeon. The effective date is September 1, 2019. The expiration date is August 31, 2020. The business address is 9 Cranbrook Blvd #102, Enfield, CT 06082. The current status is active.
| Licensee Name | MALAVIKA BANDARI |
| Credential ID | 1266512 |
| Credential Number | 1.054259 |
| Credential Type | Physician/Surgeon |
| Business Address |
9 Cranbrook Blvd #102 Enfield CT 06082 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-06-22 |
| Effective Date | 2019-09-01 |
| Expiration Date | 2020-08-31 |
| Refresh Date | 2019-10-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1281572 | CSP.0059955 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2015-05-07 | 2017-03-01 - 2019-02-28 | LAPSED |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Malavika Bandari | 705 Forrest Pointe Drive, East Greenbush, NY 12061 | Physician/surgeon | ~ |
| Street Address | 9 Cranbrook Blvd #102 |
| City | Enfield |
| State | CT |
| Zip Code | 06082 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kaitlyn A Pelligrinelli | 38 Haynes St, Enfield, CT 06082 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Sharon M Smith | 11 Eleanor Rd, Enfield, CT 06082 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Kerry A Tanguay · Lang | 11 Somers Road, Enfield, CT 06082 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Colleen E Galbraith | 12 Southview St, Enfield, CT 06082 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Paul F Misbach | 502 Taylor Road, Enfield, CT 06082 | Real Estate Salesperson | ~ |
| Catherine R Mcculloch | 84 Wynwood Drive, Enfield, CT 06082 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Phillip G Seidel | 318 North Maple St, Enfield, CT 06082 | Optician | 2020-05-01 ~ 2021-04-30 |
| Matthew Crossen | 19 Elan Street, Enfield, CT 06082 | Real Estate Salesperson | 2020-06-19 ~ 2021-05-31 |
| Baco's Pizza Inc | 410 Enfield St, Enfield, CT 06082 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Jessica G Martin | 72 Belmont Ave, Enfield, CT 06082 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Find all Licenses in zip 06082 | |||
| City | Enfield |
| Zip Code | 06082 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Enfield |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Malavika A Vidwans | One Stratford Road, Farmington, CT 06032 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Prakash Bandari Md | 75-69 113th St, Forest Hills, NY 11375 | Physician/surgeon | 1997-12-16 ~ 1999-02-28 |
| Usha M Bandari Md | 75-69 113th Street, Forest Hills, NY 11375 | Physician/surgeon | 1997-09-11 ~ 1998-11-30 |
| Prashanth Bandari | 23 Salem Ct Apt A, Glastonbury, CT 06033-1155 | Pharmacy Technician | 2011-03-18 ~ 2012-03-31 |
| Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
| John T Thompson | Physician Pavilion W, Towson, MD 21204 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Arnold R Kriegstein | College Physician, New York, NY 10032 | Physician/surgeon | 1993-04-23 ~ 1994-03-31 |
| Catherine Nguyen Keegan | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
Please comment or provide details below to improve the information on MALAVIKA BANDARI.
| 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).