DEEP S PHACHU (Credential# 1488759) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2022. The license status is ACTIVE.
DEEP S PHACHU is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.058154-RES. The credential type is resident physician. The effective date is July 1, 2020. The expiration date is June 30, 2022. The business address is 24 Park Place, Hartford, CT 06106. The current status is active.
| Licensee Name | DEEP S PHACHU |
| Credential ID | 1488759 |
| Credential Number | 1.058154-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
24 Park Place Hartford CT 06106 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-06-28 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2022-06-30 |
| Refresh Date | 2020-04-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1677717 | 1.064396 | Physician/Surgeon | 2019-10-08 | 2020-05-01 - 2021-04-30 | ACTIVE |
| 1435859 | CSP.0066179 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-07-10 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 24 Park Place |
| City | Hartford |
| State | CT |
| Zip Code | 06106 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Douglas Chu Chung | 24 Park Place, Hartford, CT 06106 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Jordan Michelle Siembor | 24 Park Place, Hartford, CT 06106 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Elena G Violari | 24 Park Place, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amruta H Panwala | 24 Park Place, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Akanksha Gupta | 24 Park Place, Hartford, CT 06106-5020 | Physician/surgeon | 2019-06-24 ~ 2020-05-31 |
| Richa Bhardwaj | 24 Park Place, Hartford, CT 06106-5021 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Shrey Patel | 24 Park Place, Hartford, CT 06106-1877 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Brian Luby | 24 Park Place, Hartford, CT 06106 | Pharmacy Technician | 2017-04-01 ~ 2018-03-31 |
| Johnn Kelson | 24 Park Place, Hartford, CT 06106 | Notary Public Appointment | 2011-01-14 ~ 2016-01-31 |
| Tatiana A Thom | 24 Park Place, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Connpirg Education Fund Inc | 2074 Park St #210, Hartford, CT 06106 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Environment Connecticut Research & Policy Center Inc | 2074 Park St, #210, Hartford, CT 06106 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Douglas Laing Rock Oyster | Statewide, Hartford, CT 06106 | Liquor Brand Label | 2016-08-03 ~ 2019-08-02 |
| Randall S Luther | 146 Wyllys St 1-203, Hartford, CT 06106 | Architect | 2020-08-01 ~ 2021-07-31 |
| Guillermina Gonzalez | 97 Amity St., Hartford, CT 06106 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Keyonni Jones | 54 Grafton St, Hartford, CT 06106 | Medication Administration Certification | ~ |
| Amber Nicole Perretta | 125 Zion St 2n, Hartford, CT 06106 | Hairdresser/cosmetician | ~ |
| Jose B. Jiminian · Danny's Market Grocery Store | 33 Park Street, Hartford, CT 06106 | Grocery Beer | 2020-08-01 ~ 2021-07-31 |
| Alice G Nieto | 29 Kelsey Street, Hartford, CT 06106 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Malinda M Rodriguez | 27 Amity Street #3, Hartford, CT 06106 | Notary Public Appointment | ~ |
| Find all Licenses in zip 06106 | |||
| City | Hartford |
| Zip Code | 06106 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + Hartford |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Deep River Oil Co Inc | Po Box 1018 500 Main St, Deep River, CT 06417 | Home Heating Fuel Dealer | 2008-10-01 ~ 2009-09-30 |
| Deep River Treasures · Kim Brennan | 158b Main St, Deep River, CT 06417 | Sterilization Permit for Bedding & Upholstered Furniture | 2005-06-17 ~ 2006-04-30 |
| Shm Deep River LLC | River Lane, Deep River, CT 06417 | Operator of Weighing & Measuring Devices | 2018-08-01 ~ 2019-07-31 |
| Deep River Hardware Co Inc | Main and Elm Street, Deep River, CT 06417 | Operator of Weighing & Measuring Devices | 2019-08-01 ~ 2020-07-31 |
| Robert L Pinsky | Po Box 164, Deep River, CT 06417-0164 | Physician/surgeon | ~ 1990-04-30 |
| Deep River Visiting Nurses | 56 High Street, Deep River, CT 06417 | Home Health Care | 2010-04-01 ~ 2012-03-31 |
| John N Deep Jr · Deep's Market | 45 North St, Danbury, CT 06810 | Grocery Beer | 2004-09-24 ~ 2005-09-23 |
| Peter S Kibbe | 17 Harvey Ln, Deep River, CT 06417-1659 | Physician/surgeon | 1982-03-12 ~ 1989-03-31 |
| Edward H Benjamin | 6 Deep Brook Hbr, Suffield, CT 06078-1454 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Elizabeth Bird | 2 Deep Hollow Rd, Chester, CT 06412-1112 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
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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).