ALI A KHODADOUST (Credential# 548443) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2018. The license expiration date date is December 31, 2018. The license status is INACTIVE.
ALI A KHODADOUST is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.030415. The credential type is physician/surgeon. The effective date is January 1, 2018. The expiration date is December 31, 2018. The business address is 46 Prince St, New Haven, CT 06519. The current status is inactive.
| Licensee Name | ALI A KHODADOUST |
| Credential ID | 548443 |
| Credential Number | 1.030415 |
| Credential Type | Physician/Surgeon |
| Business Address |
46 Prince St New Haven CT 06519 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1989-10-28 |
| Effective Date | 2018-01-01 |
| Expiration Date | 2018-12-31 |
| Refresh Date | 2019-04-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 158012 | CSP.0017829 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-03-01 - 2018-04-26 | INACTIVE |
| Street Address | 46 PRINCE ST |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06519 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John P Chandler Md | 46 Prince St, New Haven, CT 06519 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Myles A Kessler | 46 Prince St, New Haven, CT 06519-1600 | Audiologist | 2020-07-01 ~ 2021-06-30 |
| John F Kveton Md | 46 Prince St, New Haven, CT 06519 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Vinod H Srihari Md | 34 Park St Cmhc, New Haven, CT 06519 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Monica Brito Salinas | 111 Kimberly Ave., New Haven, CT 06519 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-02-28 |
| Walter Mathis | 34 Park St., New Haven, CT 06519 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kimberly Pizza · Emmanuel Zorgias | 34 Kimberly Ave, New Haven, CT 06519 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Slawomir Piascik | 51 Longhini Lane, New Haven, CT 06519 | Asbestos Abatement Supervisor | 2020-08-01 ~ 2021-07-31 |
| Margaret T Boron | 428 Columbus Ave, New Haven, CT 06519 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Laura Ann Dicola | Connecticut Mental Health Center Law & Psychiatry, New Haven, CT 06519 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Elizabeth Parson | 689 Congress Ave, New Haven, CT 06519 | Medication Administration Certification | 2020-08-05 ~ 2022-08-04 |
| Alejandra Lopez Cervantes | 10 Hedge St, New Haven, CT 06519 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-20 ~ 2021-08-31 |
| Deicy Alexandra Urena Dagua | 267 Howard Ave, New Haven, CT 06519 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-20 ~ 2021-10-31 |
| Find all Licenses in zip 06519 | |||
| City | NEW HAVEN |
| Zip Code | 06519 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Khodadoust Eye Foundation Inc | 79 Three Corners Road, Guilford, CT 06437 | Public Charity-exempt From Financial Requirements | ~ |
| Mojgan T Khodadoust | 79 Three Corners Road, Guilford, CT 06437 | Emergency Medical Technician | 2004-06-26 ~ 2006-04-01 |
| 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 |
| Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
| 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 |
| Brent Robert Jacobson | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Catherine Nguyen Keegan | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Nazanin Barzideh Md | North Shore Retina Physician, Pllc, East Hills, NY 11576 | Physician/surgeon | 2010-05-01 ~ 2011-04-30 |
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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).