RENA SHABALOVA
Physician/surgeon


Address: 3080 Voorhies Avenue Apt 2e, Brooklyn, NY 11235

RENA SHABALOVA (Credential# 1300680) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2016. The license expiration date date is April 30, 2017. The license status is INACTIVE.

Business Overview

RENA SHABALOVA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.054496-DO. The credential type is physician/surgeon. The effective date is May 1, 2016. The expiration date is April 30, 2017. The business address is 3080 Voorhies Avenue Apt 2e, Brooklyn, NY 11235. The current status is inactive.

Basic Information

Licensee Name RENA SHABALOVA
Credential ID 1300680
Credential Number 1.054496-DO
Credential Type Physician/Surgeon
Credential SubCategory DO
Business Address 3080 Voorhies Avenue Apt 2e
Brooklyn
NY 11235
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2015-08-06
Effective Date 2016-05-01
Expiration Date 2017-04-30
Refresh Date 2017-08-03

Other licenses

ID Credential Code Credential Type Issue Term Status
1315793 CSP.0061597 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2015-10-09 2015-10-09 - 2017-02-28 INACTIVE

Office Location

Street Address 3080 Voorhies avenue apt 2E
City Brooklyn
State NY
Zip Code 11235

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Edward A Kulich 1601 Voorhies Ave 2nd Fl, Brooklyn, NY 11235 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Igor Gendler 415 Brighton Beach Ave, Brooklyn, NY 11235 Tax Preparer/facilitator Permit 2020-02-11 ~ 2022-02-28
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Leonid Krupnik 2461 East 29th Street, Brooklyn, NY 11235 Professional Engineer 2020-02-01 ~ 2021-01-31
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David Merabyan 2536 E 11th Street, Brooklyn, NY 11235 Professional Engineer 2020-02-01 ~ 2021-01-31
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Competitor

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City Brooklyn
Zip Code 11235
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Brooklyn

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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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