ANOUSHIRVAN HADAEGH MD
Physician/surgeon


Address: 205 Vernon Avenue Apt 146, Vernon, CT 06066

ANOUSHIRVAN HADAEGH MD (Credential# 555560) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 24, 2000. The license expiration date date is March 31, 2001. The license status is INACTIVE.

Business Overview

ANOUSHIRVAN HADAEGH MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.037970. The credential type is physician/surgeon. The effective date is January 24, 2000. The expiration date is March 31, 2001. The business address is 205 Vernon Avenue Apt 146, Vernon, CT 06066. The current status is inactive.

Basic Information

Licensee Name ANOUSHIRVAN HADAEGH MD
Credential ID 555560
Credential Number 1.037970
Credential Type Physician/Surgeon
Business Address 205 Vernon Avenue Apt 146
Vernon
CT 06066
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1999-07-16
Effective Date 2000-01-24
Expiration Date 2001-03-31
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
216944 CSP.0028610 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 1999-03-01 - 2000-02-28 INACTIVE

Office Location

Street Address 205 VERNON AVENUE APT 146
City VERNON
State CT
Zip Code 06066

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Alexander John Bozzi 28 Deepwood Dr, Vernon, CT 06066 Home Inspector Intern 2020-05-30 ~ 2021-06-30
Kathleen N Laplaca 244 Risley Road, Vernon, CT 06066 Registered Nurse 2020-07-01 ~ 2021-06-30
Shawnda Shelton 215 East Main St. #25, Vernon, CT 06066 Medication Administration Certification 2020-06-05 ~ 2022-06-04
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Competitor

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City VERNON
Zip Code 06066
License Type Physician/Surgeon
License Type + County Physician/Surgeon + VERNON

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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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