JAYA PRASAD SHANMUGAM (Credential# 1681656) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is August 6, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
JAYA PRASAD SHANMUGAM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0072174. The credential type is controlled substance registration for practitioner. The effective date is August 6, 2019. The expiration date is February 28, 2021. The business address is 5801 Walnut Creek Rd Apt B112, River Ridge, LA 70123-5665. The current status is active.
| Licensee Name | JAYA PRASAD SHANMUGAM |
| Credential ID | 1681656 |
| Credential Number | CSP.0072174 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
5801 Walnut Creek Rd Apt B112 River Ridge LA 70123-5665 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-08-06 |
| Effective Date | 2019-08-06 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-08-07 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1652832 | 1.064027 | Physician/Surgeon | 2019-07-26 | 2019-07-26 - 2020-06-30 | ACTIVE |
| Street Address | 5801 WALNUT CREEK RD APT B112 |
| City | RIVER RIDGE |
| State | LA |
| Zip Code | 70123-5665 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Victoria Vanessa Habet | 5129 Citrus Boulevard Apt 252, Elmwood, LA 70123 | Resident Physician | 2019-07-01 ~ 2021-06-30 |
| Warren H Arms | 8728 Rosecrest Lane, River Ridge, LA 70123 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Jina B Corsetti Aprn | 10013 Sauve Oaks Lane, River Ridge, LA 70123 | Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Caitlin Michelle Weilbaecher | 9613 Garden Oak Lane, River Ridge, LA 70123 | Registered Nurse | 2018-02-24 ~ 2018-11-30 |
| Robert J Gauthreaux | 643 Grove Ave, Harahan, LA 70123 | Crane Operator | 2012-07-07 ~ 2014-07-06 |
| Elizabeth O'connor | 1201 Moss Lane, River Ridge, LA 70123 | Physical Therapist | 2015-08-01 ~ 2016-07-31 |
| Lucy A Retzlaff | 7301 Lancashire Dr, Harahan, LA 70123 | Registered Nurse | 2014-12-01 ~ 2015-11-30 |
| Latoya R Matthews | 5341 Citrus Blvd, River Ridge, LA 70123 | Registered Nurse - Temporary | 2015-10-14 ~ 2016-02-10 |
| Kimberly A Mould | 10408 Ware Street, River Ridge, LA 70123 | Registered Nurse | 2002-10-24 ~ 2003-12-31 |
| Kimberly E Landry | 499 Gordon Avenue, Harahan, LA 70123 | Registered Nurse | ~ 1999-04-30 |
| Find all Licenses in zip 70123 | |||
| City | RIVER RIDGE |
| Zip Code | 70123 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + RIVER RIDGE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Balasubramanian Shanmugam Md | 923 Farmington Ave, Bristol, CT 06010-3927 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jaya Saxena Md | 34 Maple St, Norwalk, CT 06856 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Jaya Singh | 20 Frederick St Apt 304, Hartford, CT 06105-4521 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Dayang K Jaya | 424 Texas St, San Francisco, CA 94107-2933 | Controlled Substance Registration for Practitioner | 2011-03-10 ~ 2013-02-28 |
| Jai Prasad | 32 Strawberry Hill Ct Ste 3, Stamford, CT 06902-2594 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Prasad S Sureddi | 10 Main St S, Southbury, CT 06488-2260 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Avinash Prasad Md | Neurology Specialists, Hartford, CT 06102 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Meeta Prasad | 2508 Whitney Ave Apt K, Hamden, CT 06518 | Controlled Substance Registration for Practitioner | 2006-03-20 ~ 2007-02-28 |
| Robin Prasad Md | 250 Northwest Blvd #202, Coeur D Alene, ID 83814 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Prasad Srinivasan | Allergy Assocs of Hartford PC, Glastonbury, CT 06033 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).