BINUSHA MOITHEENNAZIMA MD (Credential# 561536) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2010. The license expiration date date is May 31, 2011. The license status is INACTIVE.
BINUSHA MOITHEENNAZIMA MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.043954. The credential type is physician/surgeon. The effective date is June 1, 2010. The expiration date is May 31, 2011. The business address is 4704 N University Dr, Nacogdoches, TX 75965. The current status is inactive.
| Licensee Name | BINUSHA MOITHEENNAZIMA MD |
| Credential ID | 561536 |
| Credential Number | 1.043954 |
| Credential Type | Physician/Surgeon |
| Business Address |
4704 N University Dr Nacogdoches TX 75965 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2005-11-21 |
| Effective Date | 2010-06-01 |
| Expiration Date | 2011-05-31 |
| Refresh Date | 2011-09-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 446667 | CSP.0040097 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-09-05 | 2009-03-01 - 2011-02-28 | INACTIVE |
| Street Address | 4704 N University Dr |
| City | Nacogdoches |
| State | TX |
| Zip Code | 75965 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael K Joseph | 2614 North University Dr, Nacogdoches, TX 75965 | Pharmacist | 2012-02-01 ~ 2014-01-31 |
| Abdul R K Hashim Md | 4704 N University Dr Apt 625, Nacogdoches, TX 75965 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Benjamin Gallegos | 12518 Us Highway 259, Nacogdoches, TX 75965-8224 | Elevator Limited Conveyor Journeyperson | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eli Z Ryder | 4664 West State Hwy 21, Nacogdoches, TX 75964 | Heating, Piping & Cooling Limited Journeyperson | ~ |
| Texas Farm Products Company | Po Box 630009, Nacogdoches, TX 75963-0009 | Commercial Feed | 2017-01-01 ~ 2017-12-31 |
| Precise Pet Products | 915 S Fredonia St, Nacogdoches, TX 75964-5913 | Commercial Feed | 2017-01-01 ~ 2017-12-31 |
| Susan M Horn | 10958 County Road 302, Nacogdoches, TX 75961-7693 | Registered Nurse - Temporary | 2013-10-31 ~ 2014-02-27 |
| Dawn A Neff | 36 Austin Hollow, Nacogdoches, TX 75961 | Physical Therapist | 1997-06-09 ~ 1998-07-31 |
| Vasudeva M Bommanna | 607 Russell Blvd, Nacogdoches, TX 75961 | Physician/surgeon | 1999-10-29 ~ 2000-10-31 |
| James Hendrix | Rt 3 Box 1960, Nacogdoches, TX 75964 | Heating, Piping & Cooling Limited Journeyperson | ~ |
| Anf Specialties | 915 S Fredonia St, Nacogdoches, TX 75964-5913 | Commercial Feed | 2015-01-01 ~ 2015-12-31 |
| City | Nacogdoches |
| Zip Code | 75965 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Nacogdoches |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| 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 |
| Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
| 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 |
| 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 |
| Susan J Batlan Md | Eye Physician Associates of Hartford, West Hartford, CT 06107 | Physician/surgeon | 2000-07-27 ~ 2001-07-31 |
| 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).