ANDREW BRUCE MENDENHALL (Credential# 1380076) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is October 1, 2019. The license expiration date date is September 30, 2020. The license status is ACTIVE.
ANDREW BRUCE MENDENHALL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.055867. The credential type is physician/surgeon. The effective date is October 1, 2019. The expiration date is September 30, 2020. The business address is 3926 Ne 69th Ave, Portland, OR 97213-5133. The current status is active.
| Licensee Name | ANDREW BRUCE MENDENHALL |
| Credential ID | 1380076 |
| Credential Number | 1.055867 |
| Credential Type | Physician/Surgeon |
| Business Address |
3926 Ne 69th Ave Portland OR 97213-5133 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2016-10-25 |
| Effective Date | 2019-10-01 |
| Expiration Date | 2020-09-30 |
| Refresh Date | 2019-12-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1387212 | CSP.0064287 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-11-02 | 2017-03-01 - 2019-02-28 | LAPSED |
| 1369897 | 15 | Electrologist | - | PENDING |
| Street Address | 3926 NE 69TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-5133 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marc P Brune | 3426 Ne 60th Ave, Portland, OR 97213 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Sheila C. Gencarelli | 1914 Ne 59th Ave, Portland, OR 97213 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Bonnie F Walker | 6828 Ne Multnomah, Portland, OR 97213 | Registered Nurse | 2019-06-01 ~ 2020-05-31 |
| Suzanne Marie Zuniga | 301 Ne 65th Avenue, Portland, OR 97213 | Architect | 1999-04-09 ~ 1999-07-31 |
| Banfield Charitable Trust | Po Box 13998, Portland, OR 97213-0998 | Public Charity | 2015-01-01 ~ 2015-10-31 |
| Mark Seligman | 4505 Ne Alameda St, Portland, OR 97213-1246 | Physician/surgeon | 1976-08-17 ~ 1981-12-31 |
| Matija Louise Mclaughlin | 1525 Ne 50th Ave, Portland, OR 97213-2145 | Registered Nurse - Temporary | 2019-04-05 ~ 2019-08-03 |
| Brooke R Hammond | 5420 Ne Sandycrest Ter Apt 4, Portland, OR 97213-2650 | Licensed Clinical Social Worker | 2011-01-01 ~ 2011-12-31 |
| Credena Health LLC | 6348 Ne Halsey St Ste A, Portland, OR 97213-4720 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Peter Coppola | 3024 Ne 67th Ave, Portland, OR 97213-5204 | Physical Therapist | ~ |
| Find all Licenses in zip 97213 | |||
| City | PORTLAND |
| Zip Code | 97213 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + PORTLAND |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrew P Kauffman | 15 Mendenhall Dr, Glen Mills, PA 19342-1112 | Engineer-in-training | ~ |
| Bruce A Woda | 1 Innovation Dr, Worcester, MA 01605-4307 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Bruce P Friedman | 205 West End Ave., New York, NY 10023 | Physician/surgeon | 2004-08-30 ~ 2005-09-30 |
| Neil B Bruce | 8 Lynwood Pl Apt 12, New Haven, CT 06511-4759 | Physician/surgeon | 2016-06-01 ~ 2017-05-31 |
| R Bruce Thayer | 28 School St, Enfield, CT 06082 | Physician/surgeon | 1996-02-21 ~ 1997-04-30 |
| Bruce T Sanders | 49 Robin Ct, Poughquag, NY 12570-4508 | Physician/surgeon | 2016-04-01 ~ 2017-03-31 |
| Bruce M Molinelli Md | 31 River Road, Cos Cob, CT 06807 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Bruce Kaster | 345 N Main St, West Hartford, CT 06117-2515 | Physician/surgeon | ~ |
| Bruce D Oran | 45 E 85th St Apt 9-c, New York, NY 10028-0957 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Bruce Dickerson Md | 41 Thrush Ln, New Canaan, CT 06840 | Physician/surgeon | 2000-01-17 ~ 2001-02-28 |
Please comment or provide details below to improve the information on ANDREW BRUCE MENDENHALL.
| 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).