KEERTHI MIRYALA DDS (Credential# 949169) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.
KEERTHI MIRYALA DDS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0048593. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2011. The expiration date is February 28, 2013. The business address is 2121 Avalon Way, Shrewsbury, MA 01545-4180. The current status is inactive.
| Licensee Name | KEERTHI MIRYALA DDS |
| Credential ID | 949169 |
| Credential Number | CSP.0048593 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
2121 Avalon Way Shrewsbury MA 01545-4180 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2010-08-25 |
| Effective Date | 2011-03-01 |
| Expiration Date | 2013-02-28 |
| Refresh Date | 2014-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 933532 | 2.010270 | Dentist | 2010-06-18 | 2011-01-01 - 2011-12-31 | INACTIVE |
| Street Address | 2121 AVALON WAY |
| City | SHREWSBURY |
| State | MA |
| Zip Code | 01545-4180 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven C Jennette | 19 Rockwell Drive, Shrewsbury, MA 01545 | Architect | 2020-08-01 ~ 2021-07-31 |
| Traci L Magliozzi · Testa | 103 Stoney Hill Rd, Shrewsbury, MA 01545 | Physical Therapist | 2020-06-01 ~ 2021-05-31 |
| Geetanjali Virmani | 31 Hawthorne Road, Shrewsbury, MA 01545 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Sara M Jaszczur | 11 Turtle Creek Circle, Shrewsbury, MA 01545 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Michelle R Stumm | 9 Sycamore Road, Shrewsbury, MA 01545 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Mireya Wessolossky | 9 Old Farm Circle, Shrewsbury, MA 01545 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Esther Kinuthia | Po Box 4436, Shrewsbury, MA 01545 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Pooja Laxminarayan Jangid | 16 Thestland Dr., Shrewsbury, MA 01545 | Physical Therapist | ~ |
| Laura A Ames | 9 Chartwell Circle, Shrewsbury, MA 01545 | Nursing Home Administrator | 2020-06-01 ~ 2022-05-31 |
| Grisham M Bryan | 30 Stonybrook Lane, Shrewsbury, MA 01545 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Find all Licenses in zip 01545 | |||
| City | SHREWSBURY |
| Zip Code | 01545 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SHREWSBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Gad Lavy Md | Stamford, CT 06905 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Yuk Mng Liu | 150 Seymour St Fl 2, Waterbury, CT 06708-3754 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
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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).