JENNIFER B MATTHESEN (Credential# 1226891) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2016. The license expiration date date is November 30, 2017. The license status is INACTIVE.
JENNIFER B MATTHESEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.053345. The credential type is physician/surgeon. The effective date is December 1, 2016. The expiration date is November 30, 2017. The business address is 112 Bristol Pl, Ponte Vedra Beach, FL 32082-1523. The current status is inactive.
| Licensee Name | JENNIFER B MATTHESEN |
| Credential ID | 1226891 |
| Credential Number | 1.053345 |
| Credential Type | Physician/Surgeon |
| Business Address |
112 Bristol Pl Ponte Vedra Beach FL 32082-1523 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL; PRIOR DISCIPLINE |
| Issue Date | 2014-07-22 |
| Effective Date | 2016-12-01 |
| Expiration Date | 2017-11-30 |
| Refresh Date | 2018-03-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1239404 | CSP.0058463 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2014-08-09 | 2015-03-01 - 2017-02-28 | INACTIVE |
| 1295088 | 70 | Emergency Medical Technician | - | EXPIRED APPLICATION |
| Street Address | 112 BRISTOL PL |
| City | PONTE VEDRA BEACH |
| State | FL |
| Zip Code | 32082-1523 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marcia M. Schmidt | 169 Lamp Lighter Lane, Ponte Vedra Beach, FL 32082 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Cape Coral Portfolio, LLC | 822 N A1a Hwy, Ste 310, Ponte Vedra Beach, FL 32082 | Securities - Exemptions | 2020-03-23 ~ |
| Joshua M Buono | 173 Aruba Lane, Ponte Vedra Beach, FL 32082 | Architect | 2020-02-12 ~ 2020-07-31 |
| Monica Moore Aprn | 109 Bent Pine Court, Ponte Vedra Beach, FL 32082 | Advanced Practice Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Dawn N Cooper | 208 Avenue C, Ponte Vedra Beach, FL 32082 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Shoreline Equity Partners Feeder Fund, L.p. | 135 Professional Drive, Suite 104, Ponte Vedra Beach, CA 32082 | Securities - Exemptions | 2019-12-26 ~ |
| Saroras Hippo Gp, LLC | 961 Ponte Vedra Boulevard, Ponte Vedra Beach, FL 32082 | Securities - Exemptions | ~ |
| Shoreline Equity Partners Fund, L.p | 135 Professional Drive, Ponte Vedra Beach, FL 32082 | Securities - Exemptions | 2019-11-19 ~ |
| Erika Rogers Marino | 100 Palm Bay Ct, Ponte Vedra Beach, FL 32082 | Real Estate Salesperson | 2016-06-01 ~ 2017-05-31 |
| Anitha Patel | 8031 Pebble Creek Lane W, Ponte Vedra Beach, FL 32082 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Find all Licenses in zip 32082 | |||
| City | PONTE VEDRA BEACH |
| Zip Code | 32082 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + PONTE VEDRA BEACH |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Frances S Matthesen | 220 Giants Neck Rd, Niantic, CT 06357 | Real Estate Broker | 2005-06-30 ~ 2006-03-31 |
| Jennifer L Yeh Md | 4 Smith Dr, Savannah, GA 31406-6441 | Physician/surgeon | 2012-12-01 ~ 2013-11-30 |
| Jennifer Lax Md | 23 Old Stone Bridge Rd, Cos Cob, CT 06807-1511 | Physician/surgeon | 2003-05-16 ~ 2004-02-29 |
| Jennifer L Bau | 1 Guthrie Sq, Sayre, PA 18840-1625 | Physician/surgeon | 2017-03-01 ~ 2018-02-28 |
| Jennifer H. Kuo | 161 Fort Washington Ave Fl 8, New York, NY 10032-3729 | Physician/surgeon | ~ |
| Jennifer R Lee Md | 85 Viscount Dr#8c, Milford, CT 06460 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Jennifer B Gruen | 323 Riverside Ave, Westport, CT 06880-4810 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Jennifer P Hsu Md | 1690 Dixwell Ave., Apt 29, Hamden, CT 06514 | Physician/surgeon | 2010-12-01 ~ 2011-11-30 |
| Jennifer F Cross | 19 W Brookside Dr, Larchmont, NY 10538 | Physician/surgeon | 1992-03-24 ~ 1993-02-28 |
| Jennifer Rebecca Hill | 51-53 Kenosia Ave, Danbury, CT 06810 | Physician/surgeon | ~ |
Please comment or provide details below to improve the information on JENNIFER B MATTHESEN.
| 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).