PRIMLA H FAZALUDDIN (Credential# 544857) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2018. The license expiration date date is March 31, 2019. The license status is INACTIVE.
PRIMLA H FAZALUDDIN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.024019. The credential type is physician/surgeon. The effective date is April 1, 2018. The expiration date is March 31, 2019. The business address is 74 Bradford Walk, Farmington, CT 06032-4532. The current status is inactive.
Licensee Name | PRIMLA H FAZALUDDIN |
Credential ID | 544857 |
Credential Number | 1.024019 |
Credential Type | Physician/Surgeon |
Business Address |
74 Bradford Walk Farmington CT 06032-4532 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 1983-03-01 |
Effective Date | 2018-04-01 |
Expiration Date | 2019-03-31 |
Refresh Date | 2019-07-04 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
150400 | CSP.0012836 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2017-03-01 - 2019-02-28 | LAPSED |
Street Address | 74 BRADFORD WALK |
City | FARMINGTON |
State | CT |
Zip Code | 06032-4532 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Deborah J Almeida | 72 Bradford Walk, Farmington, CT 06032-4532 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Seema Kurup | 94 Bradford Walk, Farmington, CT 06032-4532 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Judy M Deschaine | 81 Bradford Walk, Farmington, CT 06032-4532 | Hairdresser/cosmetician | 2011-03-10 ~ 2012-05-31 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Kyeongsuk Lee Lee | 11- A1 Lakeshore Dr, Farmington, CT 06032 | Nail Technician | ~ |
Lynne M Ramer · Sobowicz | 13 Wentworth Park, Farmington, CT 06032 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
Scott's Townline Mobil LLC | 435 Main St, Farmington, CT 06032 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Glenna E Voytovich · Mietz | 47 Carriage Dr, Farmington, CT 06032 | Marital and Family Therapist | 2020-09-01 ~ 2021-08-31 |
Munsons Chocolates | 463 Westfarms Mall, Farmington, CT 06032 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Kimberly A. Caprio | Hartford Healthcare Medical Group, Farmington, CT 06032 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Stephanie A. Fink | 22 Kent Lane, Farmington, CT 06032 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Farmington Donuts LLC · Dunkins Donuts | 348 Colt Hwy, Farmington, CT 06032 | Bakery | 2020-07-01 ~ 2021-06-30 |
Angham Zakko | 2 Stratford Rd., Farmington, CT 06032 | Architect | 2020-08-01 ~ 2021-07-31 |
Thomas N Taylor | 222 Main St # 264, Farmington, CT 06032 | Architect | 2020-08-01 ~ 2021-07-31 |
Find all Licenses in zip 06032 |
City | FARMINGTON |
Zip Code | 06032 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + FARMINGTON |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
John T Thompson | Physician Pavilion W, Towson, MD 21204 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Arnold R Kriegstein | College Physician, New York, NY 10032 | Physician/surgeon | 1993-04-23 ~ 1994-03-31 |
Catherine Nguyen Keegan | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
Brent Robert Jacobson | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
Nazanin Barzideh Md | North Shore Retina Physician, Pllc, East Hills, NY 11576 | Physician/surgeon | 2010-05-01 ~ 2011-04-30 |
Sajot S Grewal Md | Danbury Office of Physician Services PC, Danbury, CT 06810 | Physician/surgeon | 2004-01-30 ~ 2005-03-31 |
Barbara A Brandes Md | Danbury Office of Physician Services, Danbury, CT 06810 | Physician/surgeon | 2004-07-08 ~ 2005-07-31 |
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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).