KETANKUMAR SHAH (Credential# 1296275) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
KETANKUMAR SHAH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0060778. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 5 Fairway Ct, Edison, NJ 08820-3665. The current status is active.
| Licensee Name | KETANKUMAR SHAH |
| Credential ID | 1296275 |
| Credential Number | CSP.0060778 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
5 Fairway Ct Edison NJ 08820-3665 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-06-25 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1283104 | 1.054281 | Physician/Surgeon | 2015-06-24 | 2019-10-01 - 2020-09-30 | ACTIVE |
| Street Address | 5 FAIRWAY CT |
| City | EDISON |
| State | NJ |
| Zip Code | 08820-3665 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Vasant B Chokshi | 6 Sussex Court, Edison, NJ 08820 | Professional Engineer | 1993-02-02 ~ 1994-01-31 |
| Rajnikant Doshi | 2 Libby Court, Edison, NJ 08820 | Professional Engineer | 2020-02-14 ~ 2021-01-31 |
| Owais Ahmad | 702 Denver Blvd, Edison, NJ 08820 | Professional Engineer | 2020-02-04 ~ 2021-01-31 |
| Shamsah B Sonawalla | 116 Clive Street, Edison, NJ 08820 | Physician/surgeon | 2018-11-01 ~ 2019-10-31 |
| Umapathi Jagarlamudi | 19 Jonathan Dr, Edison, NJ 08820 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Kapil Varshney | 27 Monmouth Ave, Edison, NJ 08820 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Swaroop C Puchalapalli | 31 Newburg Dr, Edison, NJ 08820 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Dipak S Choksi | 23 Hansen Drive, Edison, NJ 08820 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Ghazali A Chaudry | 115 Stephenville Parkway, Edison, NJ 08820 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Wen-long Yao | 34 Heather Dr., Edison, NJ 08820 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Find all Licenses in zip 08820 | |||
| City | EDISON |
| Zip Code | 08820 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + EDISON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ketankumar Patel | 20 York Street, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Hajra Shah | Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Darshan J Shah | 139 Hazard Ave Ste 1-4, Enfield, CT 06082-4583 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Abid Shah | 140 Kyles Way, Shelton, CT 06484 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Suvarna M Shah Md | 9 Mott Ave, Norwalk, CT 06850 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Parth S Shah | 10 Norwood Way, Avon, CT 06001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Suresh M Shah Md | 29 Cascade Rd, W Hartford, CT 06117 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Jai Shah | 34 Park Street, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Ravi Shah | 171 Lake Ave, Colonia, NJ 07067-1354 | Controlled Substance Registration for Practitioner | 2020-04-15 ~ 2021-02-28 |
| Amit A Shah | 20 York St # 209, New Haven, CT 06512 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
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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).