MARYAM ZEHTABPOUR (Credential# 1319008) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2016. The license expiration date date is August 31, 2017. The license status is INACTIVE.
MARYAM ZEHTABPOUR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003476. The credential type is physician assistant. The effective date is September 1, 2016. The expiration date is August 31, 2017. The business address is 6 Stony Hill Rd, Bethel, CT 06801-1053. The current status is inactive.
| Licensee Name | MARYAM ZEHTABPOUR |
| Credential ID | 1319008 |
| Credential Number | 23.003476 |
| Credential Type | Physician Assistant |
| Business Address |
6 Stony Hill Rd Bethel CT 06801-1053 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2015-11-10 |
| Effective Date | 2016-09-01 |
| Expiration Date | 2017-08-31 |
| Refresh Date | 2017-12-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1372455 | CSP.0063826 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-08-17 | 2016-08-17 - 2017-02-28 | INACTIVE |
| Street Address | 6 STONY HILL RD |
| City | BETHEL |
| State | CT |
| Zip Code | 06801-1053 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Wine World of Bethel | 6 Stony Hill Rd, Bethel, CT 06801-1053 | Lottery Sales Agent | 2020-01-07 ~ 2021-03-31 |
| Doris E Bowlby · Wine World of Bethel | 6 Stony Hill Rd, Bethel, CT 06801-1053 | Package Store Liquor | 2020-03-25 ~ 2021-03-24 |
| Stony Hill Vol. Fire Co. | 6 Stony Hill Rd, Bethel, CT 06801-1053 | Certified Ems Organization | 2020-01-01 ~ 2020-12-31 |
| Chaplain Service of Connecticut Inc | 6 Stony Hill Rd, Bethel, CT 06801-1053 | Public Charity | 2018-12-01 ~ 2019-11-30 |
| William B Rizzuto Jr · Rizzuto's Wood Fire Pizza Kitchen | 6 Stony Hill Rd, Bethel, CT 06801-1053 | Restaurant Liquor | 2018-10-01 ~ 2019-09-30 |
| William P Gardner IIi · Wine World of Bethel | 6 Stony Hill Rd, Bethel, CT 06801-1053 | Package Store Liquor | 2013-01-11 ~ 2014-01-10 |
| Jnj Solutions LLC · Drapery Couture | 6 Stony Hill Rd, Bethel, CT 06801 | Home Improvement Contractor | 2005-12-01 ~ 2006-11-30 |
| Lorraine Asnip | 6 Stony Hill Rd, Bethel, CT 06801 | Real Estate Salesperson | 1996-06-01 ~ 1997-05-31 |
| Michael Hayek · Bottega Wood Fired Pizza | 6 Stony Hill Rd, Bethel, CT 06801-1053 | Cafe Liquor | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John Anthony Dulko | 6 Winthrop Road, Bethel, CT 06801 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Antonietta Sproviero-metaxas | 36 Quaker Ridge Road, Bethel, CT 06801 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Mark K Roos | 6 Crestview Road, Bethel, CT 06801 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Susan Nguyen | 14b Cawley Ave., Bethel, CT 06801 | Esthetician | ~ |
| Blue Jay Orchards | 125 Plumtrees Rd, Bethel, CT 06801 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Varano Bakery | 198 Greenwood Ave, Bethel, CT 06801 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Nina M Kilcourse | 3 Bayberry Hill Rd, Bethel, CT 06801 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Ralph Ramsdell · Big Y | 83 Stony Hill Road, Bethel, CT 06801 | Grocery Beer | 2020-04-18 ~ 2021-04-17 |
| Marilu F Jeton | 36 Weed Rd, Bethel, CT 06801 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Petagay V Hewitt | 44 Greenwood Avenue, Bethel, CT 06801 | Real Estate Salesperson | ~ |
| Find all Licenses in zip 06801 | |||
| City | BETHEL |
| Zip Code | 06801 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + BETHEL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Maryam Gondal | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2015-06-24 ~ 2020-06-30 |
| Maryam Ahmed | 64 Robbins St, Waterbury, CT 06708-2613 | Resident Physician | 2019-06-10 ~ 2022-06-22 |
| Maryam Tanweer | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-06-10 ~ 2022-06-21 |
| Maryam Bakhshandeh | 760 Westchester Avenue, Rye Brook, NY 10573 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Maryam Saleem | 64 Robbins Street, Room 3304, Waterbury, CT 06708 | Resident Physician | 2017-06-12 ~ 2020-06-30 |
| Maryam Zulfiqar | Yale Child Study Center, 230 S Frontage Rd, New Haven, CT 06519 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| Physician Assistant Foundation of The American Academy of Physician Assistants | 2318 Mill Rd Ste 1300, Alexandria, VA 22314-6868 | Public Charity | 2019-12-01 ~ 2020-11-30 |
| Theresa V Horvath | Physiican Assistant Institute, Bridgeport, CT 06604 | Physician Assistant | 2018-10-01 ~ 2019-09-30 |
| Quinnipiac University Physician Assistant Student Society | 370 Bassett Rd, North Haven, CT 06473-4201 | Raffle Permit Class 1 | 2017-01-12 ~ 2017-04-08 |
| Connecticut Dermatology Physician Assistant Society Inc. | Po Box 847, Manchester, CT 06045 | Public Charity-exempt From Financial Requirements | ~ |
Please comment or provide details below to improve the information on MARYAM ZEHTABPOUR.
| 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).