KIRUBAKARAN SIVA (Credential# 1448354) 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 INACTIVE.
KIRUBAKARAN SIVA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0066710. 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 80 Winter Ln, Tewksbury, MA 01876-2256. The current status is inactive.
| Licensee Name | KIRUBAKARAN SIVA |
| Credential ID | 1448354 |
| Credential Number | CSP.0066710 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
80 Winter Ln Tewksbury MA 01876-2256 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LACK OF ACTIVE MEDICAL LICENSE |
| Issue Date | 2017-09-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-04-20 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1436483 | 1.056893-DO | Physician/Surgeon | 2017-08-17 | 2018-12-01 - 2019-11-30 | INACTIVE |
| 1489412 | 1.058618-RES | Resident Physician | 2015-07-01 | 2015-07-01 - 2018-06-30 | INACTIVE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kirubakaran Siva | 5305 Archstone Ave, Tewksbury, MA 01876-1872 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Street Address | 80 WINTER LN |
| City | TEWKSBURY |
| State | MA |
| Zip Code | 01876-2256 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Raymonna F Dube | 841 Main Street, Tewksbury, MA 01876 | Real Estate Salesperson | 2019-06-01 ~ 2020-05-31 |
| Cellia N Jordan | 1417 Whipple Rd, Tewksbury, MA 01876 | Pharmacy Technician | 2020-05-13 ~ 2021-03-31 |
| Debra A Antonelli · Sunderland | 70 Greenmeadow Drive, Tewksbury, MA 01876 | Hairdresser/cosmetician | 2020-06-01 ~ 2022-05-31 |
| Northstar Engineering Services Pllc | 2 Highwood Dr, Tewksbury, MA 01876 | Professional Engineering Corporation | 2020-04-24 ~ 2021-04-23 |
| Eric R Kuegler | 203 Kendall Rd, Tewksbury, MA 01876 | Professional Engineer | 2020-02-03 ~ 2021-01-31 |
| Vincent W Spada | 160 Kendall Rd, Tewksbury, MA 01876 | Professional Engineer | 2014-02-01 ~ 2015-01-31 |
| Giancarlo G Botazzi | 28 Magna Vista Circle, Tewksbury, MA 01876 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Ann M Long | 231 Lancaster Dr, Tewksbury, MA 01876 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Robert B Adams | 50 Wellington Circle, Tewksbury, MA 01876 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Jeffrey S Dirk | 18 Rhoda St, Tewksbury, MA 01876 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Find all Licenses in zip 01876 | |||
| City | TEWKSBURY |
| Zip Code | 01876 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + TEWKSBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Subra - Siva Md | 30 Ridgewood Rd, Woodbury, CT 06798-3814 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Siva Padmanabhan Sivakumar | 38 Ericka Cicle, East Longmeadow, MA 01028 | Controlled Substance Registration for Practitioner | 2019-12-18 ~ 2021-02-28 |
| Siva Yadlapati Md · Univ of Conn Health Ctr | Div of Homatology/oncology, Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 1998-03-01 ~ 1999-02-28 |
| Siva Construction Inc | 17 Lafayette Avenue, Ridgefield, CT 06877 | Home Improvement Contractor | 1995-02-01 ~ 1995-11-30 |
| Sergio I Vazquez · Siva Construction Co Inc | 17 Lafayette Ave, Ridgefield, CT 06877 | Home Improvement Contractor | 1995-02-21 ~ 1995-11-30 |
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on KIRUBAKARAN SIVA.
| 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).