GRACE N GATHUNGU MD (Credential# 563027) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2011. The license expiration date date is December 31, 2011. The license status is INACTIVE.
GRACE N GATHUNGU MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.045445. The credential type is physician/surgeon. The effective date is January 1, 2011. The expiration date is December 31, 2011. The business address is 25 Horizon View Dr, Farmingville, NY 11738-3046. The current status is inactive.
| Licensee Name | GRACE N GATHUNGU MD |
| Credential ID | 563027 |
| Credential Number | 1.045445 |
| Credential Type | Physician/Surgeon |
| Business Address |
25 Horizon View Dr Farmingville NY 11738-3046 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2007-05-30 |
| Effective Date | 2011-01-01 |
| Expiration Date | 2011-12-31 |
| Refresh Date | 2012-04-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 529715 | CSP.0045353 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-04-09 | 2009-04-09 - 2011-02-28 | INACTIVE |
| 410640 | CSP.0037797 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-07-18 | 2008-03-25 - 2009-02-28 | INACTIVE |
| Street Address | 25 HORIZON VIEW DR |
| City | FARMINGVILLE |
| State | NY |
| Zip Code | 11738-3046 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Quingguo You | 5 Arctic Court, Farmingville, NY 11738 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Paul N Dapontes | 16 Sachem Court, Farmingville, NY 11738 | Notary Public Appointment | 2003-02-10 ~ 2008-02-29 |
| Umair Siddiqui | 107 Cedar Oaks Ave, Farmingville, NY 11738 | Pharmacist | ~ |
| George Angelis · Eagle Chimney Maintenance | 32 Eva Lane, Farmingville, NY 11738 | Home Improvement Contractor | 2005-12-01 ~ 2006-11-30 |
| All American Chimney | 27 Liber Blvd, Farmingville, NY 11738 | Home Improvement Contractor | 2007-12-01 ~ 2008-11-30 |
| Vanessa Fallica | 15 Ridgedale Ave, Farmingville, NY 11738 | Physician Assistant | ~ |
| Tanya M Neilsen | 1007 Old Medford Avenue, Farmingville, NY 11738 | Physical Therapist | 2013-03-01 ~ 2014-02-28 |
| Suzanne Montalbano | 8 Faculty Lane, Farmingville, NY 11738 | Real Estate Salesperson | ~ |
| Gary G. Koster | 52 Oakdale Avenue, Farmingville, NY 11738 | Certified Public Accountant License | 2008-01-01 ~ 2008-12-31 |
| Marian Wronkowski | 45 Crestwood Lane, Farmingville, NY 11738 | Asbestos Abatement Worker | 2009-01-06 ~ 2010-01-31 |
| Find all Licenses in zip 11738 | |||
| City | FARMINGVILLE |
| Zip Code | 11738 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + FARMINGVILLE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Grace Cha | 38 Ward St Apt 5, Middletown, CT 06457-4185 | Physician/surgeon | ~ |
| Grace S Lee | 27 Stacey Ln, Madison, CT 06443-2465 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Grace P Kim Md | 169 Cheesespring Rd, Wilton, CT 06897-2308 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Grace K Suh Md | 641 Whitney Ave 2c, New Haven, CT 06511-2253 | Physician/surgeon | 2007-01-18 ~ 2008-03-31 |
| Grace Chang | 17 Hillhouse Ave, New Haven, CT 06511-8965 | Physician/surgeon | 1984-07-05 ~ 1992-02-29 |
| Jaspreet S. Joneja | 14 Grace Dr, Old Westbury, NY 11568-1221 | Physician/surgeon | 2011-04-06 ~ 2011-12-31 |
| Grace H Lee | 631 East 6th Street, Hinsdale, IL 60521 | Physician/surgeon | 2009-05-26 ~ 2010-07-31 |
| Grace K Mandigo | 2150 Broadway # 126, New York, NY 10023-8255 | Physician/surgeon | ~ |
| Grace Jenq Md | 55 Hickory Rd, Woodbridge, CT 06525 | Physician/surgeon | 2016-05-01 ~ 2017-04-30 |
| Grace M Jere Md | 12 Bailey Rd, Middletown, CT 06457 | Physician/surgeon | 2006-01-17 ~ 2007-02-28 |
Please comment or provide details below to improve the information on GRACE N GATHUNGU MD.
| 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).