MARIVIC D BOTTA MD (Credential# 562881) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
MARIVIC D BOTTA MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.045299. The credential type is physician/surgeon. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 15 Corporate Drive, Trumbull, CT 06611. The current status is active.
| Licensee Name | MARIVIC D BOTTA MD |
| Credential ID | 562881 |
| Credential Number | 1.045299 |
| Credential Type | Physician/Surgeon |
| Business Address |
15 Corporate Drive Trumbull CT 06611 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2007-04-19 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-02-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 466782 | CSP.0041287 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-04-30 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 15 CORPORATE DRIVE |
| City | TRUMBULL |
| State | CT |
| Zip Code | 06611 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael Cassetta Do | 15 Corporate Drive, Trumbull, CT 06611 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Tom K Coffey Md | 15 Corporate Drive, Trumbull, CT 06611 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Martha Yepes Small Md | 15 Corporate Drive, Trumbull, CT 06611 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Steven A Fisher | 15 Corporate Drive, Trumbull, CT 06611 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Glenn M Rich | 15 Corporate Drive, Trumbull, CT 06611 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Arthur S Turetsky | 15 Corporate Drive, Trumbull, CT 06611 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Stephanie Merck Aprn | 15 Corporate Drive, Trumbull, CT 06611 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Renee Alfano-kostenko | 15 Corporate Drive, Trumbull, CT 06611 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Donald L Butler | 15 Corporate Drive, Trumbull, CT 06611 | Physician/surgeon | 2005-01-14 ~ 2006-02-28 |
| Hodson | 15 Corporate Drive, Trumbull, CT 06611 | Lead Consultant Contractor | ~ 2000-02-29 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ashley S Balestriere | 7 Sutton Place, Trumbull, CT 06611 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Filomena L Ferraro · Nicolia | 35 Skating Pond Rd, Trumbull, CT 06611 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Alexis Grace Shaub | 58 Chestnut Hill Road, Trumbull, CT 06611 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Maria Bivona | 5302 Main Street, Trumbull, CT 06611 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Gina M Gallo · Liquigli | 20 Red Maple Lane, Trumbull, CT 06611 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Xuehuan Zhang | 31 Asbury Rd, Trumbull, CT 06611 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Antoinette D Senior | 38 Tanager Lane, Trumbull, CT 06611 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Solution Construction LLC | 3 Stonewall Lane, Trumbull, CT 06611 | New Home Construction Contractor | 2020-06-18 ~ 2021-09-30 |
| Gary T Sorge | 63 Limerick Road, Trumbull, CT 06611 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Melodie T Noga | 55 Moose Hill Road, Trumbull, CT 06611 | Real Estate Salesperson | 2020-06-19 ~ 2021-05-31 |
| Find all Licenses in zip 06611 | |||
| City | TRUMBULL |
| Zip Code | 06611 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + TRUMBULL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marivic F Factura | 244 Michelle Circle, Edison, NJ 08820 | Physician/surgeon | ~ 1998-09-30 |
| Joseph J Botta | 150 Ware Rd, Dayville, CT 06241-1126 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Robert K Botta | 6 Research Dr, Ste 105, Shelton, CT 06484 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Donald M Botta | Po Box 208039, New Haven, CT 06520-8039 | Physician/surgeon | 2011-05-01 ~ 2012-04-30 |
| Thomas A Botta | 22 Cobblers Mill Road, Sandy Hook, CT 06482 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Marivic L Sarol | 8860 S.mobile Ave Apt 1c, Oak Lawn, IL 60453 | Physical Therapist | ~ |
| Marivic Sabaoan | 59 Liberty St., Unit 28, Stamford, CT 06902 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Marivic Picarra | 228 Serenity Crest St, Henderson, NV 89012-5304 | Home Improvement Salesperson | 2016-12-01 ~ 2017-11-30 |
| Gabrielle A Botta | 12 Buena Vista Dr, Unionville, CT 06085-1377 | Hairdresser/cosmetician | 2017-08-01 ~ 2019-07-31 |
| Brian K Botta | 465 Woodward Ave, New Haven, CT 06512 | Home Improvement Salesperson | 2007-12-01 ~ 2008-11-30 |
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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).