LUCY ANN SALIEB SHAMBERG (Credential# 1281947) 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.
LUCY ANN SALIEB SHAMBERG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0060069. 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 2890 Main St, Stratford, CT 06614-4980. The current status is active.
| Licensee Name | LUCY ANN SALIEB SHAMBERG |
| Credential ID | 1281947 |
| Credential Number | CSP.0060069 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
2890 Main St Stratford CT 06614-4980 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-05-18 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1468926 | 1.060284 | Physician/Surgeon | 2018-04-11 | 2019-12-01 - 2020-11-30 | ACTIVE |
| 1488826 | 1.058221-RES | Resident Physician | 2015-07-01 | 2015-07-01 - 2018-06-30 | INACTIVE |
| Street Address | 2890 MAIN ST |
| City | STRATFORD |
| State | CT |
| Zip Code | 06614-4980 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrew Bedford Md | 2890 Main St, Stratford, CT 06614-4980 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Gregory N Soloway | 2890 Main St, Stratford, CT 06614-4980 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael E Opalak | 2890 Main St Ste D, Stratford, CT 06614-4980 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Patrick P Mastroianni | 2890 Main St Ste D, Stratford, CT 06614-4980 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nicole Marie Minaudo | 80 Barrows Ter, Stratford, CT 06614 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Constance Greene | 65 Pamela Drive, Stratford, CT 06614 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Courtney M Blaze | 90 Mercer Street, Stratford, CT 06614 | Massage Therapist | 2020-07-01 ~ 2022-06-30 |
| William E Rosner Md | 81 B Seminole Lane, Stratford, CT 06614 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Demetrius I Mcqueen | 60 Emerald Pl, Stratford, CT 06614 | Real Estate Salesperson | 2020-06-26 ~ 2021-05-31 |
| Alan Goldberg | 1825 Barnum Ave, Stratford, CT 06614 | Dentist | 2020-09-01 ~ 2021-08-31 |
| Kimberly L Matakevich | 1367 Nichols Avenue, Stratford, CT 06614 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Marybeth Nemergut | 990 Chapel St, Stratford, CT 06614 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Geraldine C Corry | 135 Wigwam Lane, Stratford, CT 06614 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Kathleen Sajgovic | 300 Post Oak Rd, Stratford, CT 06614 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06614 | |||
| City | STRATFORD |
| Zip Code | 06614 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + STRATFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lucy H Kapur | 820 W Smith St, Orlando, FL 32804-5228 | Controlled Substance Registration for Practitioner | 2013-07-08 ~ 2015-02-28 |
| Lucy Ruangvoravat | 50 Lyon St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-08-16 ~ 2021-02-28 |
| Lucy Rovito | 1 Jamie Ct #d1, Suffern, NY 10901-7016 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Emily Lucy Germain-lee | 118 Westerly Ter, Hartford, CT 06105-1117 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lucy Burciaga Md | 80 Renshaw Road, Hamden, CT 06518 | Controlled Substance Registration for Practitioner | 2003-03-01 ~ 2004-02-28 |
| Lucy Zhang | 20 York Street, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2015-04-20 ~ 2017-02-28 |
| 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 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
Please comment or provide details below to improve the information on LUCY ANN SALIEB SHAMBERG.
| 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).