Anisha .

Registration Number:
1100108
Last Name:
.
Given Name:
Anisha
Former Last Name:

Registration Information

Current Registration Category:
Practitioner
Current Registration Status:
Revoked – non-renewal
Designations(s):
Authorized for Independent Practice (has professional liability insurance):
No

Registration History

Initial Registration Information:

Initial Registration Date:
12/13/2022 1:06:41 PM
Initial Registration Category:
Practitioner
Status:
Active
Subsequent Changes in Category and/or Status are Listed below:

  Date Category Change Status Change

Date of ChangeNew CategoryNew Status
7/17/2023 5:32:07 PMSuspended
10/2/2023 5:23:40 PMRevoked – non-renewal