PHANTHILA SINGHAVIRANON MD (Credential# 353382) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.
PHANTHILA SINGHAVIRANON MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0034283. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2013. The expiration date is February 28, 2015. The business address is 229 Canterbury Cir, East Longmeadow, MA 01028-5709. The current status is inactive.
| Licensee Name | PHANTHILA SINGHAVIRANON MD |
| Credential ID | 353382 |
| Credential Number | CSP.0034283 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
229 Canterbury Cir East Longmeadow MA 01028-5709 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 2013-03-01 |
| Expiration Date | 2015-02-28 |
| Refresh Date | 2016-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 559320 | 1.041737 | Physician/Surgeon | 2003-08-01 | 2013-12-01 - 2014-11-30 | INACTIVE |
| Street Address | 229 CANTERBURY CIR |
| City | EAST LONGMEADOW |
| State | MA |
| Zip Code | 01028-5709 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Chandra Mohan Manish | 132 Canterbury Cir, East Longmeadow, MA 01028-5709 | Dentist | 2020-03-01 ~ 2021-02-28 |
| Jennifer L Rivers Aprn | 221 Canterbury Cir, East Longmeadow, MA 01028-5709 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kathleen Stezko | 29 Autumn Ridge, East Longmeadow, MA 01028 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Sergy Chebotarev | 38 Lenox Circle, East Longmeadow, MA 01028 | Tax Preparer/facilitator Permit | 2020-06-18 ~ 2022-06-30 |
| Breanna Lynn Cloonan | 11 Acorn Street, East Longmeadow, MA 01028 | Physical Therapist Assistant | 2020-07-01 ~ 2021-06-30 |
| Maureen Teresa Blanchard | 70 Somers Rd, East Longmeadow, MA 01028 | Esthetician | ~ |
| Erica J Mcnamara | 30 Villanova Street, East Longmeadow, MA 01028 | Real Estate Salesperson | 2020-06-15 ~ 2021-05-31 |
| Jerry E Gray | C/o Abide Inc., East Longmeadow, MA 01028 | Lead Abatement Supervisor | 2020-09-01 ~ 2021-08-31 |
| Devin T Mccorison | C/o Abide, Inc., East Longmeadow, MA 01028 | Asbestos Abatement Supervisor | 2020-09-01 ~ 2021-08-31 |
| Susan B Chunyk | Hampden Hearing Ctr, East Longmeadow, MA 01028 | Audiologist | 2020-08-01 ~ 2021-07-31 |
| Mario Tascon | 202 Canterbury Circle, East Longmeadow, MA 01028 | Real Estate Salesperson | 2020-06-08 ~ 2021-05-31 |
| Jeong Ja Lee | 25 Robin St, East Longmeadow, MA 01028 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Find all Licenses in zip 01028 | |||
| City | EAST LONGMEADOW |
| Zip Code | 01028 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + EAST LONGMEADOW |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| 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 |
| Lily Singhaviranon Md | 442 Buckland Dr, Cheshire, CT 06410-4146 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Zung W Kim Md | 265 Purchase St, Rye, NY 10580 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
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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).