ANN R DATUNASHVILI (Credential# 557521) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
ANN R DATUNASHVILI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.039938. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 291 Bear Hill Rd, Bethany, CT 06524-3228. The current status is active.
Licensee Name | ANN R DATUNASHVILI |
Credential ID | 557521 |
Credential Number | 1.039938 |
Credential Type | Physician/Surgeon |
Business Address |
291 Bear Hill Rd Bethany CT 06524-3228 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2001-10-16 |
Effective Date | 2020-04-01 |
Expiration Date | 2021-03-31 |
Refresh Date | 2020-02-14 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1172340 | CSP.0055295 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-07-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
292893 | CSP.0031615 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2001-11-23 | 2017-03-01 - 2021-02-28 | ACTIVE |
1164898 | CSP.0054726 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-05-23 | 2015-03-01 - 2017-02-28 | INACTIVE |
Street Address | 291 BEAR HILL RD |
City | BETHANY |
State | CT |
Zip Code | 06524-3228 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
David Tkeshelashvili | 291 Bear Hill Rd, Bethany, CT 06524-3228 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Jordan Sarah Young | 285 Bear Hill Rd, Bethany, CT 06524-3228 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
Jars of Clay, Contracting & Design LLC | 281 Bear Hill Rd, Bethany, CT 06524-3228 | Home Improvement Contractor | 2016-12-01 ~ 2017-11-30 |
Alex B Macnamara | 287 Bear Hill Rd, Bethany, CT 06524-3228 | Emergency Medical Responder | 2018-08-03 ~ 2021-04-01 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Catherine M Ford · Porto | 78 Tuttle Court, Bethany, CT 06524 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
Erin Mcknight | 24 Timber Ln, Bethany, CT 06524 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Cheryl A Bevvino | 106 Sperry Rd, Bethany, CT 06524 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Catherine Geloso | 19 Amadeo Drive, Bethany, CT 06524 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
Patricia Burke | 12 Miller Rd, Bethany, CT 06524 | Veterinarian | 2020-09-01 ~ 2021-08-31 |
Complete Excavating Services LLC | 674 Amity Rd, Bethany, CT 06524 | Demolition Contractor | 2020-07-01 ~ 2021-06-30 |
Brian K Coutermarsh | 32 Emerald Lane, Bethany, CT 06524 | Radiographer | 2020-09-01 ~ 2021-08-31 |
Michelle L Amato | 172 Russell Rd, Bethany, CT 06524 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
Joseph L Colaci | 57 Edwards Road, Bethany, CT 06524 | Nursing Home Administrator | 2020-05-01 ~ 2022-04-30 |
Karen C Praskievicz | 85 Sperry Rd, Bethany, CT 06524 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Find all Licenses in zip 06524 |
City | BETHANY |
Zip Code | 06524 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + BETHANY |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
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 |
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 |
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).