SHANNON R PACKER (Credential# 1180459) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
SHANNON R PACKER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0055966. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 68 Chatham Dr, Manchester, CT 06042-8521. The current status is active.
| Licensee Name | SHANNON R PACKER |
| Credential ID | 1180459 |
| Credential Number | CSP.0055966 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
68 Chatham Dr Manchester CT 06042-8521 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2013-08-20 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1174562 | 23.002946 | Physician Assistant | 2013-08-07 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 68 CHATHAM DR |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06042-8521 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brian A Karwaski | 68 Chatham Dr, Manchester, CT 06042-8521 | Physician Assistant | 2020-09-01 ~ 2021-08-31 |
| Cheryl C Smith | 68 Chatham Dr, Manchester, CT 06042-8521 | Real Estate Salesperson | 2011-06-01 ~ 2012-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Melissa Aiello | 118 Tudor Lane Apt. I, Manchester, CT 06042 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Michelle Carolyn Hayes | 129 Rachel Rd, Harford, CT 06042 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Guotong Quan | 348 Kennedy Road, 348 Kennedy Road, CT 06042 | Nail Technician | 2020-06-26 ~ 2022-03-31 |
| Charity Boakye | 103 Rachel Rd,unit B, Manchester, CT 06042 | Licensed Practical Nurse | ~ |
| Jordan M Kaiser | 40 Tanner St, Manchester, CT 06042 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Tandra Gomes | 80 Alton St., Manchester, CT 06042 | Medication Administration Certification | 2020-05-08 ~ 2022-05-07 |
| James Power | 16 Lawton Rd., Manchester, CT 06042 | Medication Administration Certification | 2018-08-03 ~ 2020-08-02 |
| Tierra Amerson | 66 Phelps Rd., Manchester, CT 06042 | Medication Administration Certification | 2018-07-02 ~ 2020-07-01 |
| Lisa A Surdam | 22 Greenwood Drive, Manchester, CT 06042 | Notary Public Appointment | 2020-06-01 ~ 2025-05-31 |
| Sharon Morin | 15 Hartland Rd, Manchester, CT 06042 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Find all Licenses in zip 06042 | |||
| City | MANCHESTER |
| Zip Code | 06042 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MANCHESTER |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jonathan D Packer | 227 Church Street, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Phoebe J Packer | 1273 Boulevard, West Hartford, CT 06119-1603 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Shannon S Maher | 16 Cat Rock Rd, Cos Cob, CT 06807-1704 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Shannon T Ormsbee | 209 Timberlake Dr, Fayetteville, NC 28314-1241 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Shannon L Oteri | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Shannon E Demas | 242 S. Whitney St., Hartford, CT 06105 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Shannon P Marsh | 114 Woodland St, Hartford, CT 06105-1208 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Shannon L Degroff | 11 Acre Way, Southington, CT 06489-2253 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Shannon B Widderick Pa | 354 Birnie Ave, Springfield, MA 01107-1108 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Shannon M Lynch | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).