SREENIVASA R PATIBANDLA
Physician/surgeon


Address: 177 White Plains Road, Apt #21b, Tarrytown, NY 10591

SREENIVASA R PATIBANDLA (Credential# 556677) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 27, 2002. The license expiration date date is July 31, 2003. The license status is INACTIVE.

Business Overview

SREENIVASA R PATIBANDLA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.039089. The credential type is physician/surgeon. The effective date is June 27, 2002. The expiration date is July 31, 2003. The business address is 177 White Plains Road, Apt #21b, Tarrytown, NY 10591. The current status is inactive.

Basic Information

Licensee Name SREENIVASA R PATIBANDLA
Credential ID 556677
Credential Number 1.039089
Credential Type Physician/Surgeon
Business Address 177 White Plains Road, Apt #21b
Tarrytown
NY 10591
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2000-10-31
Effective Date 2002-06-27
Expiration Date 2003-07-31
Refresh Date 2009-07-08

Office Location

Street Address 177 White Plains Road, Apt #21B
City Tarrytown
State NY
Zip Code 10591

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Competitor

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City Tarrytown
Zip Code 10591
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Tarrytown

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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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