BALASUBRAMANIAN SHANMUGAM MD (Credential# 379435) 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 ACTIVE.
BALASUBRAMANIAN SHANMUGAM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0035715. 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 923 Farmington Ave, Bristol, CT 06010-3927. The current status is active.
| Licensee Name | BALASUBRAMANIAN SHANMUGAM MD |
| Credential ID | 379435 |
| Credential Number | CSP.0035715 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
923 Farmington Ave Bristol CT 06010-3927 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2004-09-15 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-07 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 563749 | 1.046167 | Physician/Surgeon | 2008-01-30 | 2019-11-01 - 2020-10-31 | ACTIVE |
| Street Address | 923 FARMINGTON AVE |
| City | BRISTOL |
| State | CT |
| Zip Code | 06010-3927 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Richard M Zweig | 923 Farmington Ave, Bristol, CT 06010 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Your Eyes of Bristol Inc | 927 Farmington Ave, Bristol, CT 06010-3927 | Optical Selling Permit | 2019-09-01 ~ 2020-08-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Deborah M Dube · Adamaitis | 33 Peck Lane, Bristol, CT 06010 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Barbara M Williams | 45 Harrison Street, Bristol, CT 06010 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| Le Bao Linh Nguyen | 229 Silo Rd, Bristol, CT 06010 | Nail Technician | ~ |
| Tara M Chipman | 38 Grove St, Bristol, CT 06010 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Jaclyn J Brandolini | 424 Emmett St, Bristol, CT 06010 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Hoa Le | 63 Seminary St, Bristol, CT 06010 | Nail Technician | ~ |
| Barbara E Trench | 25 Peacedale St, Bristol, CT 06010 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Tisha A Balfour | 379 West Street, Bristol, CT 06010 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Meredith Rose Martineau | 15 Bishop Street, Bristol, CT 06010 | Master's Level Social Worker - Temporary Permit | 2020-06-26 ~ 2020-09-06 |
| Jaime L Krueger | 130 Garfield Road, Bristol, CT 06010 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Find all Licenses in zip 06010 | |||
| City | BRISTOL |
| Zip Code | 06010 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRISTOL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Balasubramanian Bhagavath | 101 Dudley Street, Providence, RI 02905 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Harinarayan Balasubramanian | 7 Austin Circle, So Windsor, CT 06074 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Jaya Prasad Shanmugam | 5801 Walnut Creek Rd Apt B112, River Ridge, LA 70123-5665 | Controlled Substance Registration for Practitioner | 2019-08-06 ~ 2021-02-28 |
| 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 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
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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).