ANITA M ZACHARIAH MD
Physician/surgeon


Address: 1389 W Main St Suite 120, Waterbury, CT 06708

ANITA M ZACHARIAH MD (Credential# 562399) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 9, 2007. The license expiration date date is September 30, 2008. The license status is INACTIVE.

Business Overview

ANITA M ZACHARIAH MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.044817. The credential type is physician/surgeon. The effective date is August 9, 2007. The expiration date is September 30, 2008. The business address is 1389 W Main St Suite 120, Waterbury, CT 06708. The current status is inactive.

Basic Information

Licensee Name ANITA M ZACHARIAH MD
Credential ID 562399
Credential Number 1.044817
Credential Type Physician/Surgeon
Business Address 1389 W Main St Suite 120
Waterbury
CT 06708
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2006-10-03
Effective Date 2007-08-09
Expiration Date 2008-09-30
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
453450 CSP.0040785 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2006-10-19 2007-03-01 - 2008-02-29 INACTIVE

Office Location

Street Address 1389 W MAIN ST SUITE 120
City WATERBURY
State CT
Zip Code 06708

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City WATERBURY
Zip Code 06708
License Type Physician/Surgeon
License Type + County Physician/Surgeon + WATERBURY

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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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