NILOUFAR H SHOUSHTARI MD
Physician/surgeon


Address: 16 Spring Valley Road, East Longmeadow, MA 01028

NILOUFAR H SHOUSHTARI MD (Credential# 553418) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is November 17, 1999. The license expiration date date is January 31, 2001. The license status is INACTIVE.

Business Overview

NILOUFAR H SHOUSHTARI MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.035825. The credential type is physician/surgeon. The effective date is November 17, 1999. The expiration date is January 31, 2001. The business address is 16 Spring Valley Road, East Longmeadow, MA 01028. The current status is inactive.

Basic Information

Licensee Name NILOUFAR H SHOUSHTARI MD
Credential ID 553418
Credential Number 1.035825
Credential Type Physician/Surgeon
Business Address 16 Spring Valley Road
East Longmeadow
MA 01028
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1997-02-07
Effective Date 1999-11-17
Expiration Date 2001-01-31
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
47535 CSP.0025257 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 1999-03-01 - 2000-02-28 INACTIVE

Office Location

Street Address 16 SPRING VALLEY ROAD
City EAST LONGMEADOW
State MA
Zip Code 01028

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Kathleen Stezko 29 Autumn Ridge, East Longmeadow, MA 01028 Registered Nurse 2020-09-01 ~ 2021-08-31
Sergy Chebotarev 38 Lenox Circle, East Longmeadow, MA 01028 Tax Preparer/facilitator Permit 2020-06-18 ~ 2022-06-30
Breanna Lynn Cloonan 11 Acorn Street, East Longmeadow, MA 01028 Physical Therapist Assistant 2020-07-01 ~ 2021-06-30
Maureen Teresa Blanchard 70 Somers Rd, East Longmeadow, MA 01028 Esthetician ~
Erica J Mcnamara 30 Villanova Street, East Longmeadow, MA 01028 Real Estate Salesperson 2020-06-15 ~ 2021-05-31
Jerry E Gray C/o Abide Inc., East Longmeadow, MA 01028 Lead Abatement Supervisor 2020-09-01 ~ 2021-08-31
Devin T Mccorison C/o Abide, Inc., East Longmeadow, MA 01028 Asbestos Abatement Supervisor 2020-09-01 ~ 2021-08-31
Susan B Chunyk Hampden Hearing Ctr, East Longmeadow, MA 01028 Audiologist 2020-08-01 ~ 2021-07-31
Mario Tascon 202 Canterbury Circle, East Longmeadow, MA 01028 Real Estate Salesperson 2020-06-08 ~ 2021-05-31
Jeong Ja Lee 25 Robin St, East Longmeadow, MA 01028 Combination Nail Technician, Esthetician Or Eyelash Technici ~
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Competitor

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City EAST LONGMEADOW
Zip Code 01028
License Type Physician/Surgeon
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Dataset Information

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).

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