INDRANI H DATTA MD (Credential# 561797) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
INDRANI H DATTA MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.044215. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 130 Division St, Derby, CT 06418. The current status is active.
| Licensee Name | INDRANI H DATTA MD |
| Credential ID | 561797 |
| Credential Number | 1.044215 |
| Credential Type | Physician/Surgeon |
| Business Address |
130 Division St Derby CT 06418 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2006-04-03 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-04-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 442456 | CSP.0039399 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-07-14 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 130 DIVISION ST |
| City | DERBY |
| State | CT |
| Zip Code | 06418 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ricardo Concepcion Gomez | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Anwesh Poosala | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Da Young Ryu | 130 Division St, Derby, CT 06418 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Genevieve C Kela | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Inshiya Dawoodi | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Sovit Dahal | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Rosa Constantino | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Ivanshi Gondalia | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Angad Gill | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Douglas Palacios | 130 Division St, Derby, CT 06418-1326 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Debra A Montini | 8 Academy Hill Ext, Derby, CT 06418 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Laura M Boanno | 131 Marshall La, Derby, CT 06418 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Danyun Chen | 49 Pershing Dr., Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Fan Geng | Shoprite Shopping Center, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Danni Xu | Shoprite Shopping Center49 Pershing Dr, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Yao Zhang | Shoprite Shopping Center 49 Pershing Dr, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Phillip N Burke | 3 Camptown St, Derby, CT 06418 | Emergency Medical Technician | 2017-06-07 ~ 2020-06-30 |
| Diane A Rosner | 229 Shagbark Drive, Derby, CT 06418 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Pamela C Lavelle | 194 Minerva St, Derby, CT 06418 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Grade A Market - Derby LLC | 49 Pershing Dr, Derby, CT 06418 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06418 | |||
| City | DERBY |
| Zip Code | 06418 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + DERBY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Indrani Malkani | Pediatric Center, Putnam, CT 06260 | Physician/surgeon | 2003-08-22 ~ 2004-09-30 |
| Indrani P Saini | 170 Mohegan Trail, South Windsor, CT 06074 | Physician/surgeon | 2001-07-05 ~ 2002-08-31 |
| Subhajit Datta | 71 Bywater Drive, Getzville, NY 14068 | Physician/surgeon | 2000-06-21 ~ 2001-07-31 |
| Cristina Gioioso-datta | 103 North Main Street, Branford, CT 06405 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Rupak Datta | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2016-07-01 ~ 2021-06-30 |
| Rahul Datta | 129 York St Apt 5j, New Haven, CT 06511-5605 | Resident Physician | 2015-06-29 ~ 2019-06-30 |
| Soum Datta Lokeshwar | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-06-09 ~ 2021-06-30 |
| Neil Datta | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2014-06-28 ~ 2018-06-30 |
| Indrani Bagchi | 207 Barncroft Rd, Stamford, CT 06902-1207 | Behavior Analyst | 2020-07-01 ~ 2021-06-30 |
| Indrani Chakraborty | 59 Haren Drive, Rocky Hill, CT 06067 | Notary Public Appointment | 2016-07-11 ~ 2021-07-31 |
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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).