SHIVI SHARMA
Physician/surgeon


Address: 665 Commerce Dr Apt 408, Fairfield, CT 06825-5569

SHIVI SHARMA (Credential# 994083) 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.

Business Overview

SHIVI SHARMA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.050213. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 665 Commerce Dr Apt 408, Fairfield, CT 06825-5569. The current status is active.

Basic Information

Licensee Name SHIVI SHARMA
Credential ID 994083
Credential Number 1.050213
Credential Type Physician/Surgeon
Business Address 665 Commerce Dr Apt 408
Fairfield
CT 06825-5569
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2011-08-10
Effective Date 2020-04-01
Expiration Date 2021-03-31
Refresh Date 2020-03-25

Other licenses

ID Credential Code Credential Type Issue Term Status
2057241 CSP.0074578 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2020-06-19 2020-06-19 - 2021-02-28 APPROVED
509722 CSP.0044076 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2008-08-06 2019-03-01 - 2021-02-28 ACTIVE

Office Location

Street Address 665 COMMERCE DR APT 408
City FAIRFIELD
State CT
Zip Code 06825-5569

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City FAIRFIELD
Zip Code 06825
License Type Physician/Surgeon
License Type + County Physician/Surgeon + FAIRFIELD

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Dataset Information

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).

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