AGEDI N BOTO (Credential# 1322133) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
AGEDI N BOTO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.055202. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 58 Southfield Rd, Fairfield, CT 06824. The current status is active.
| Licensee Name | AGEDI N BOTO |
| Credential ID | 1322133 |
| Credential Number | 1.055202 |
| Credential Type | Physician/Surgeon |
| Business Address |
58 Southfield Rd Fairfield CT 06824 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2016-05-02 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-03-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1076028 | CSP.0052568 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2012-07-02 | 2012-07-02 - 2013-02-28 | INACTIVE |
| Street Address | 58 Southfield Rd |
| City | Fairfield |
| State | CT |
| Zip Code | 06824 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Amy S Van Buren | 11 Larkspur Road, Fairfield, CT 06824 | Massage Therapist | 2020-08-01 ~ 2022-07-31 |
| Linda J Batchelder | 72 Ruane St, Fairfield, CT 06824 | Architect | 2020-08-01 ~ 2021-07-31 |
| Fairfield American Little League | 87 Charles St, Fairfield, CT 06824 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Robert D Sickeler | 175 Wakeman Rd, Fairfield, CT 06824 | Architect | 2020-08-01 ~ 2021-07-31 |
| Michael P Brennan | 338 Sturges Rd, Fairfield, CT 06824 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Maria A Arduini | 499 Hemlock Rd, Fairfield, CT 06824 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Ryan L Antisdale | 104 Rhoda Avenue, Fairfield, CT 06824 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Szymlinska Eva Jucelin | 105 Churchill Street, Fairfield, CT 06824 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Afoofa, Inc · Afoofa | 298 South Benson Road, Fairfield, CT 06824 | Public Charity-exempt From Financial Requirements | 2020-06-25 ~ |
| Rachel Finlaw | 2546 North Benson Road, Fairfield, CT 06824 | Master's Level Social Worker | ~ |
| Find all Licenses in zip 06824 | |||
| City | Fairfield |
| Zip Code | 06824 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Fairfield |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
| 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 |
| 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 |
| Brent Robert Jacobson | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Catherine Nguyen Keegan | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Nazanin Barzideh Md | North Shore Retina Physician, Pllc, East Hills, NY 11576 | Physician/surgeon | 2010-05-01 ~ 2011-04-30 |
| Sajot S Grewal Md | Danbury Office of Physician Services PC, Danbury, CT 06810 | Physician/surgeon | 2004-01-30 ~ 2005-03-31 |
| Susan J Batlan Md | Eye Physician Associates of Hartford, West Hartford, CT 06107 | Physician/surgeon | 2000-07-27 ~ 2001-07-31 |
Please comment or provide details below to improve the information on AGEDI N BOTO.
| 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).