ANURUDDHA WALALIYADDA (Credential# 554629) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
ANURUDDHA WALALIYADDA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.037039. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 687 Campbell Ave, West Haven, CT 06516-3774. The current status is active.
Licensee Name | ANURUDDHA WALALIYADDA |
Credential ID | 554629 |
Credential Number | 1.037039 |
Credential Type | Physician/Surgeon |
Business Address |
687 Campbell Ave West Haven CT 06516-3774 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 1998-07-02 |
Effective Date | 2020-06-01 |
Expiration Date | 2021-05-31 |
Refresh Date | 2020-04-07 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
2056144 | CSP.0074538 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2020-06-17 | 2020-06-17 - 2021-02-28 | ACTIVE |
2054956 | CSP.0074501 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2020-06-17 | 2020-06-17 - 2021-02-28 | ACTIVE |
2056141 | CSP.0074536 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2020-06-17 | 2020-06-17 - 2021-02-28 | ACTIVE |
2056143 | CSP.0074537 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2020-06-17 | 2020-06-17 - 2021-02-28 | ACTIVE |
156028 | CSP.0027394 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
1408889 | CSP.0064888 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
1327494 | CSP.0061919 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-01-06 | 2019-03-01 - 2021-02-28 | ACTIVE |
1387957 | CSP.0064313 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-11-05 | 2019-03-01 - 2021-02-28 | ACTIVE |
1189930 | CSP.0056297 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-10-19 | 2019-03-01 - 2021-02-28 | ACTIVE |
1791156 | CSP.0072536 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-10-04 | 2019-10-04 - 2021-02-28 | ACTIVE |
1634654 | CSP.0070340 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-02-26 | 2019-02-26 - 2021-02-28 | ACTIVE |
1435455 | CSP.0066143 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-07-06 | 2019-03-01 - 2021-02-28 | ACTIVE |
423361 | CSP.0038603 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-12-06 | 2019-03-01 - 2021-02-28 | ACTIVE |
492929 | CSP.0043046 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-01-29 | 2019-03-01 - 2021-02-28 | ACTIVE |
1616031 | CSP.0069890 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-11-21 | 2018-11-21 - 2019-02-28 | INACTIVE |
1442071 | CSP.0066568 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-08-10 | 2017-08-10 - 2019-02-28 | INACTIVE |
1230895 | CSP.0057602 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2014-06-25 | 2015-03-01 - 2017-02-28 | INACTIVE |
1161934 | CSP.0054651 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-05-07 | 2015-03-06 - 2017-02-28 | INACTIVE |
1262514 | CSP.0059231 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2015-02-07 | 2015-02-07 - 2017-02-28 | INACTIVE |
897341 | CSP.0046777 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-10-19 | 2013-03-01 - 2015-02-28 | INACTIVE |
994464 | CSP.0050014 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2011-04-27 | 2011-04-27 - 2013-02-28 | INACTIVE |
1039127 | CSP.0051606 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2011-11-02 | 2011-11-02 - 2013-02-28 | INACTIVE |
423821 | CSP.0038614 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-12-13 | 2011-03-10 - 2013-02-28 | INACTIVE |
520293 | CSP.0044898 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-12-05 | 2011-03-01 - 2013-02-28 | INACTIVE |
316272 | CSP.0032622 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-03-01 - 2011-02-28 | INACTIVE | |
1230897 | CSP.0057603 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | - | INACTIVE |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Anuruddha Walaliyadda · The Mary Wade Home | 118 Clinton Ave, New Haven, CT 06513-3100 | Controlled Substance Registration for Practitioner | 2016-11-16 ~ 2017-02-28 |
Street Address | 687 CAMPBELL AVE |
City | WEST HAVEN |
State | CT |
Zip Code | 06516-3774 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Minori Korn | 687 Campbell Ave, West Haven, CT 06516-3774 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
Benedict L. L Fernando Md | 687 Campbell Ave, West Haven, CT 06516 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
Joseph A. Balsamo | 687 Campbell Ave, West Haven, CT 06516-3774 | Controlled Substance Registration for Practitioner | 2019-06-19 ~ 2021-02-28 |
Benedict Fernando Md | 687 Campbell Ave, West Haven, CT 06516-3774 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Lena Wu Rivas | 687 Campbell Avenue, West Haven, CT 06516-3774 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Nancy Cabrera Salinas | 649 Third Ave., West Haven, CT 06516 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-07-31 |
Lauralee L Gaglio | 27 Peppermill Drive, West Haven, CT 06516 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
Evelyn Ruiz Conant | 309 Terrace Ave, Unit 42, West Haven, CT 06516 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
Junqin Wang | 15 Central Ave West Haven, West Haven, CT 06516 | Nail Technician | ~ |
Mehmet Sofuoglu Md | Va Conn Healthcare System, West Haven, CT 06516 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
Monica M Skakacz | 19 Cowpen Rd, West Haven, CT 06516 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
Lourdes Maribel Guzman | 26 York Street, West Haven, CT 06516 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
Mcdonald's · Tay Mac Dba | 1129 Campbell Ave, West Haven, CT 06516 | Bakery | 2020-07-01 ~ 2021-06-30 |
Dyaija Soriano | 29 Ridge Court East, West Haven, CT 06516 | Esthetician | 2020-06-26 ~ 2022-05-31 |
Katherine M Grable | 13 Perry Merrill Drive, West Haven, CT 06516 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
Find all Licenses in zip 06516 |
City | WEST HAVEN |
Zip Code | 06516 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + WEST HAVEN |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
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 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).