BIJAN K BASAK (Credential# 542715) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 24, 1992. The license expiration date date is March 31, 1993. The license status is INACTIVE.
BIJAN K BASAK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.018194. The credential type is physician/surgeon. The effective date is April 24, 1992. The expiration date is March 31, 1993. The business address is Lakeside Mem Hosp, Brockport, NY 14420. The current status is inactive.
| Licensee Name | BIJAN K BASAK |
| Credential ID | 542715 |
| Credential Number | 1.018194 |
| Credential Type | Physician/Surgeon |
| Business Address |
Lakeside Mem Hosp Brockport NY 14420 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1988-05-18 |
| Effective Date | 1992-04-24 |
| Expiration Date | 1993-03-31 |
| Refresh Date | 2009-07-08 |
| Street Address | LAKESIDE MEM HOSP |
| City | BROCKPORT |
| State | NY |
| Zip Code | 14420 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sarah Colapietro | 2962 Colby St, Brockport, NY 14420 | Registered Nurse | 2019-08-01 ~ 2020-07-31 |
| Thomas G Shafer | 243 Willowbrooke Drive, Brockport, NY 14420 | Registered Nurse - Temporary | 2015-07-13 ~ 2015-11-09 |
| Paul V Bissanti | 800 Gilmore Road, Brockport, NY 14420 | Hairdresser/cosmetician | 1997-07-31 ~ 1998-04-30 |
| James Manno · Kb Transport Inc | 200 State Street, Brockport, NY 14420 | Transporter Liquor | 2001-01-08 ~ 2002-01-07 |
| Richard J King | 3845 Lake Rd N, Brockport, NY 14420-1419 | Controlled Substance Registration for Practitioner | 2015-02-07 ~ 2017-02-28 |
| Carrie Lynn Kumar | 82 Monroe Ave, Brockport, NY 14420-1823 | Registered Nurse | 2012-12-03 ~ 2013-12-31 |
| Timothy J Russell | 47 Spring St, Brockport, NY 14420-2045 | Tv & Radio Limited Dish Antenna Technician | ~ |
| Lauren R Fery | 19 Old Elm Dr, Brockport, NY 14420-2511 | Physical Therapist | 2013-07-01 ~ 2014-06-30 |
| Caitlin E Myers | 211 Hollybrook Rd, Brockport, NY 14420-2533 | Registered Nurse | 2012-04-01 ~ 2013-03-31 |
| City | BROCKPORT |
| Zip Code | 14420 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + BROCKPORT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ratna B. Basak | 19 Locust St, Greenvale, NY 11548-1110 | Physician/surgeon | 2014-01-01 ~ 2014-12-31 |
| Bijan Parsi | Po Box 559, Rhinebeck, NY 12572 | Pharmacist | 2009-02-01 ~ 2010-01-31 |
| Bijan Bandani | 12 9th Street, Medford, MA 02155 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Bijan Behzadi | 474 Clark St, Bridgeport, CT 06606 | Electrical Unlimited Journeyperson | ~ |
| Bijan Ghayour | 15 Circle Drive, Dover, MA 02030 | Professional Engineer | 2003-02-03 ~ 2004-01-31 |
| Bijan Behzadi | 820 Daniel's Farms Rd, Trumbull, CT 06611 | Electrical Unlimited Contractor | 2019-10-01 ~ 2020-09-30 |
| Bijan Pashanamaei | 2704 Baynard Blvd, Wilmington, DE 19802 | Professional Engineer | 1996-02-01 ~ 1997-01-31 |
| Bijan Bahramian | 129 Lydale Place, Meriden, CT 06450 | Notary Public Appointment | 2016-02-01 ~ 2021-01-31 |
| David Basak-smith | Monroe Town & Country Vet Hospital, Monroe, CT 06468 | Controlled Substance Registration for Practitioner | 2019-05-09 ~ 2021-02-28 |
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
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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).