ZINAIDA BOUTAEVA MD (Credential# 563932) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
ZINAIDA BOUTAEVA MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.046350. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 4 Pump Lane, Ridgefield, CT 06877. The current status is active.
| Licensee Name | ZINAIDA BOUTAEVA MD |
| Credential ID | 563932 |
| Credential Number | 1.046350 |
| Credential Type | Physician/Surgeon |
| Business Address |
4 Pump Lane Ridgefield CT 06877 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2008-03-26 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-01-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 507057 | CSP.0043735 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-07-03 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 4 pump lane |
| City | ridgefield |
| State | CT |
| Zip Code | 06877 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kathleen Morrin | 169 Nod Road, Ridgefield, CT 06877 | Radiographer | 2020-09-01 ~ 2021-08-31 |
| Elena Yakimova | 8 Lawson Lane, Ridgefield, CT 06877 | Dental Hygienist | 2020-07-01 ~ 2021-06-30 |
| Jasmine Gannalo | 35 Clearview Dr, Ridgefield, CT 06877 | Esthetician | 2020-06-26 ~ 2022-06-30 |
| Nicole A Van Alstyne | 105 Stonecrest Road, Ridgefield, CT 06877 | Real Estate Salesperson | ~ |
| Andrea A Delange · Ledina | 5 Copper Beech Lane, Ridgefield, CT 06877 | Physical Therapist | 2020-09-01 ~ 2021-08-31 |
| Mitchell O Hubsher | 77 Chestnut Hill Road, Ridgefield, CT 06877 | Naturopathic Physician | 2020-07-01 ~ 2021-06-30 |
| Milillo Farms | 424 R Main St, Ridgefield, CT 06877 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Marie G Donofrio | 36 Woodlawn Dr, Ridgefield, CT 06877 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Jennifer M Kinford | 40 Woodland Way, Ridgefield, CT 06877 | Esthetician | ~ |
| Lauren Elizabeth Pambianchi | 49 11 Levels Road, Ridgefield, CT 06877 | Registered Nurse | ~ |
| Find all Licenses in zip 06877 | |||
| City | ridgefield |
| Zip Code | 06877 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + ridgefield |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Zinaida Matlyuk Md | 1 Leighton St Unit 1713, Cambridge, MA 02141-1871 | Physician/surgeon | 2010-08-01 ~ 2011-07-31 |
| Zinaida Mahnken | 150 E 85th St Apt 2b, New York, NY 10028-2301 | Hairdresser/cosmetician | 2012-11-15 ~ 2014-05-31 |
| Zinaida Lovishchuk | 22 Promontory Dr, Cheshire, CT 06410 | Hairdresser/cosmetician | 2010-06-01 ~ 2012-05-31 |
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
| Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| 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 |
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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).