SUBODHKUMAR SUNDARAM MD (Credential# 561386) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2013. The license expiration date date is November 30, 2014. The license status is INACTIVE.
SUBODHKUMAR SUNDARAM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.043804. The credential type is physician/surgeon. The effective date is December 1, 2013. The expiration date is November 30, 2014. The business address is 4019 Woodland Road, Annandale, VA 22003. The current status is inactive.
| Licensee Name | SUBODHKUMAR SUNDARAM MD |
| Credential ID | 561386 |
| Credential Number | 1.043804 |
| Credential Type | Physician/Surgeon |
| Business Address |
4019 Woodland Road Annandale VA 22003 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2005-09-12 |
| Effective Date | 2013-12-01 |
| Expiration Date | 2014-11-30 |
| Refresh Date | 2015-03-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 416064 | CSP.0038321 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-09-15 | 2008-03-01 - 2009-02-28 | INACTIVE |
| 464455 | CSP.0041179 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-03-06 | 2008-03-01 - 2009-02-28 | INACTIVE |
| Street Address | 4019 Woodland Road |
| City | Annandale |
| State | VA |
| Zip Code | 22003 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robert B Raines | 3344 Monarch Lane, Annandale, VA 22003 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Paul C O'brien | 8312 Kay Court, Annandale, VA 22003 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Amy Kristine Bronick | 4906 English Drive, Annandale, VA 22003 | Registered Nurse | 2018-10-01 ~ 2019-09-30 |
| Soyeon Lee | 7401 Eastmoreland Road, Annandale, VA 22003 | Massage Therapist | 2020-02-01 ~ 2022-01-31 |
| William R Debesis | 8701 Rosedale Lane, Annandale, VA 22003 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Charles Valases | 8021 Garlot Dr, Annandale, VA 22003 | Physician/surgeon | 2019-05-01 ~ 2020-04-30 |
| Kaveh Mehrnama | 4309 Gifford Pinchot Drive, Annandale, VA 22003 | Professional Engineer | 2015-02-01 ~ 2016-01-31 |
| Gkco Inc | 5007 Althea Dr, Annandale, VA 22003 | Professional Engineer | 1991-01-03 ~ 1992-01-31 |
| Reymond L Nordlund · Spncr,white&prentis Inc | 4806 Bristow Dr, Annandale, VA 22003 | Professional Engineer | 1989-02-08 ~ 1990-01-31 |
| Rosemary R Stewart | 7511 Ramblewood Crt, Annandale, VA 22003 | Registered Nurse | 2012-12-01 ~ 2013-11-30 |
| Find all Licenses in zip 22003 | |||
| City | Annandale |
| Zip Code | 22003 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Annandale |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Uma Sundaram | 219 Highland Ave, Wallingford, CT 06492 | Physician/surgeon | 1995-04-19 ~ 1996-05-31 |
| Sundaram V Ramanan | 18 Tabor Circle, West Hartford, CT 06117-1474 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Sundaram Solai | 3 Clarendon Ct, West Windsor, NJ 08550-2025 | Professional Engineer | 2019-12-03 ~ 2021-01-31 |
| Vidya A Sundaram | 31 Maplewood Ave, West Hartford, CT 06119-1630 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Vishalakshi Sundaram Md | 333 North State Road, Briarcliff Manor, NY 10510 | Controlled Substance Registration for Practitioner | 2013-06-19 ~ 2015-02-28 |
| 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 |
| John T Thompson | Physician Pavilion W, Towson, MD 21204 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Arnold R Kriegstein | College Physician, New York, NY 10032 | Physician/surgeon | 1993-04-23 ~ 1994-03-31 |
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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).