SAMATHA BAGAM (Credential# 564599) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 23, 2008. The license expiration date date is November 30, 2008. The license status is INACTIVE.
SAMATHA BAGAM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.047017. The credential type is physician/surgeon. The effective date is September 23, 2008. The expiration date is November 30, 2008. The business address is 17513 89th Ave, Jamaica, NY 11432. The current status is inactive.
| Licensee Name | SAMATHA BAGAM |
| Credential ID | 564599 |
| Credential Number | 1.047017 |
| Credential Type | Physician/Surgeon |
| Business Address |
17513 89th Ave Jamaica NY 11432 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2008-09-23 |
| Effective Date | 2008-09-23 |
| Expiration Date | 2008-11-30 |
| Refresh Date | 2009-07-08 |
| Street Address | 17513 89th Ave |
| City | Jamaica |
| State | NY |
| Zip Code | 11432 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mi Ok Kim | 175-06 Devonshire Rd #3g, Jamaica Estates, NY 11432 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Saurav Debnath | 170-07 Hillside Ave, Jamaica, NY 11432 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Kitty Ko | 82-07 165 Street 1st Floor, Jamaica, NY 11432 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Estephany Meliza Valerio-negron | 9011 160th St Apt B205, Jamaica, NY 11432 | Licensed Clinical Social Worker | ~ |
| Daniel Pacificador | 85-17 Parsons Blvd, Jamaica, NY 11432 | Tax Preparer/facilitator Permit | 2020-02-11 ~ 2022-02-28 |
| Md Harunur R Miah | 8750 Kingston Pl, Apt# 1h, Jamaica, NY 11432 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Rajcoomar Autar | 165-14 Chapin Parkway, Jamaica, NY 11432 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Sabita Rani Sarkar | 168-07,89th Ave,apt#d4, Jamaica, NY 11432 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Elina Yakubov | 181-18 Kildare Rd, Jamaica, NY 11432 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Ahilan Thurairajah | 183-11 Hillside Avenue, Jamaica, NY 11432 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Find all Licenses in zip 11432 | |||
| City | Jamaica |
| Zip Code | 11432 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Jamaica |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Samatha K Kadiyala Md | 615 Thoreau Circle, Windsor, CT 06095 | Physician/surgeon | 2009-07-23 ~ 2010-06-30 |
| Samatha L Najman | 54 Wilson Rd, Wolcott, CT 06416 | Pharmacy Technician | 2020-04-01 ~ 2021-03-31 |
| Samatha Kanumuru | 7 Walcott Green, South Windsor, CT 06074 | Pharmacy Technician | 2008-04-01 ~ 2009-03-31 |
| Samatha Benjamin | 735 Blue Hills Ave, Bloomfield, CT 06002 | Medication Administration Certification | 2004-11-23 ~ 2006-11-22 |
| Samatha Kowalewski | 460 Capitol Avenue, Hartford, CT 06106 | Medication Administration Certification | 2015-07-27 ~ 2017-07-26 |
| Samatha D. Bertrand | 28 Saint Regis Ave., Norwich, CT 06360 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| 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 |
| John T Thompson | Physician Pavilion W, Towson, MD 21204 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Please comment or provide details below to improve the information on SAMATHA BAGAM.
| 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).