KISHANRAO BOGAVELLI (Credential# 546744) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2010. The license expiration date date is August 31, 2011. The license status is INACTIVE.
KISHANRAO BOGAVELLI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.027725. The credential type is physician/surgeon. The effective date is September 1, 2010. The expiration date is August 31, 2011. The business address is 29 Culvert Street, Portjervis, NY 12771. The current status is inactive.
| Licensee Name | KISHANRAO BOGAVELLI |
| Credential ID | 546744 |
| Credential Number | 1.027725 |
| Credential Type | Physician/Surgeon |
| Business Address |
29 Culvert Street Portjervis NY 12771 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1986-10-16 |
| Effective Date | 2010-09-01 |
| Expiration Date | 2011-08-31 |
| Refresh Date | 2011-12-02 |
| Street Address | 29 Culvert Street |
| City | Portjervis |
| State | NY |
| Zip Code | 12771 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeanette Collazo | 569 Old Mountain Road, Port Jervis, NY 12771 | Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Alexander Quick | 6 Lyman Ave, Port Jervis, NY 12771 | Repairer of Weighing & Measuring Devices | 2015-02-26 ~ 2015-12-31 |
| Robert E Habig | 20 Kingston Ave, Port Jervis, NY 12771 | Architect | 1999-08-01 ~ 2000-07-31 |
| Derek L Somerville | 25 Buckley Street, Port Jervis, NY 12771 | Occupational Therapist Assistant | 2008-05-23 ~ 2009-07-31 |
| William P Kowal | 4 Court Helaine, Port Jenis, NY 12771 | Occupational Therapist Assistant | ~ 1995-07-31 |
| Meghann A Collins | 37 Sussex Street, Port Jervis, NY 12771 | Professional Counselor | 2007-04-20 ~ 2008-05-31 |
| Kim J Decker | 39 Church St #29, Port Jervis, NY 12771 | Registered Nurse | 1993-02-25 ~ 1993-09-30 |
| Marcolino M Andalis | 721 Minisimk Tpke, Port Jervis, NY 12771 | Respiratory Care Practitioner | 2002-12-02 ~ 2004-01-31 |
| Janice S Mortenson | Town of Greenville, Port Jervis, NY 12771 | Registered Nurse | 2006-09-18 ~ 2007-08-31 |
| Katherine C Moshinski · Empire Hm Mdrnztn Inc (s) | 132 Ball St, Port Jervis, NY 12771 | Home Improvement Salesperson | ~ 1994-01-01 |
| Find all Licenses in zip 12771 | |||
| City | Portjervis |
| Zip Code | 12771 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Portjervis |
| 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 |
| Arnold R Kriegstein | College Physician, New York, NY 10032 | Physician/surgeon | 1993-04-23 ~ 1994-03-31 |
| John T Thompson | Physician Pavilion W, Towson, MD 21204 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| 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 M Galko Md | Danbury Office of Physician Services PC, Danbury, CT 06810 | Physician/surgeon | 2010-06-01 ~ 2011-05-31 |
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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).