ELIZABETH A BUNDOCK (Credential# 1399471) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2019. The license expiration date date is December 31, 2019. The license status is INACTIVE.
ELIZABETH A BUNDOCK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.056445. The credential type is physician/surgeon. The effective date is January 1, 2019. The expiration date is December 31, 2019. The business address is 160 Pine Haven Shores Lane, Shelburne, VT 05482. The current status is inactive.
Licensee Name | ELIZABETH A BUNDOCK |
Credential ID | 1399471 |
Credential Number | 1.056445 |
Credential Type | Physician/Surgeon |
Business Address |
160 Pine Haven Shores Lane Shelburne VT 05482 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 2017-05-11 |
Effective Date | 2019-01-01 |
Expiration Date | 2019-12-31 |
Refresh Date | 2020-06-08 |
Street Address | 160 Pine Haven Shores Lane |
City | Shelburne |
State | VT |
Zip Code | 05482 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Emma D Williams | 123 Grey Rock Road, Shelburne, VT 05482 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
Michael Nathan Boggs | 1141 Falls Rd, Shelburne, VT 05482 | Physician/surgeon | ~ |
Cory M Savino | 287 Locust Hill Rd, Shelburne, VT 05482 | Registered Nurse | 2019-03-05 ~ 2020-03-31 |
Morgan L Marlow | 67 Hunters Way, Shelburne, VT 05482 | Engineer-in-training | 2017-09-12 ~ 2027-09-12 |
Maya E Shapiro-miller | 94 Butternut Lane, Shelburne, VT 05482 | Master's Level Social Worker | 2015-01-07 ~ 2015-07-31 |
Audrey W Sweeten | 2110 The Terraces, Shelburne, VT 05482 | Real Estate Broker | 2006-04-01 ~ 2007-03-31 |
Domenico Grasso | 40 Old Stage Lane, Shelburne, VT 05482 | Professional Engineer | 2013-02-01 ~ 2014-01-31 |
Unibrew Usa Inc | 145 Pine Haven Shores Road Ste 2013, Shelburne, VT 05482 | Out of State Shipper Beer | 2010-08-11 ~ 2011-08-10 |
Wendy E Gerle | 31 Edward Dr., Shelburne, VT 05482 | Licensed Clinical Social Worker | 2000-07-24 ~ 2001-07-31 |
Krista M Duffy | 452 Acorn Lane, Shelburne, VT 05482 | Licensed Clinical Social Worker | 2005-12-27 ~ 2006-12-31 |
Find all Licenses in zip 05482 |
City | Shelburne |
Zip Code | 05482 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + Shelburne |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Elizabeth Bundock | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 1999-03-20 ~ 2001-03-19 |
Nicole Caldwell | 240 Elizabeth St # H1-120, Elizabeth, CO 80107-7537 | Physician/surgeon | 2015-03-01 ~ 2016-02-29 |
Elizabeth Baorto | 360 3rd St Ste 425, San Francisco, CA 94107-2164 | Physician/surgeon | ~ |
Frederick Lu | Po Box 546, Elizabeth, NJ 07207 | Physician/surgeon | 1994-05-06 ~ 1995-04-30 |
Nina R Rivera | 141 Elizabeth St, Hartford, CT 06105-2211 | Physician/surgeon | ~ |
Elizabeth C Glass Md | 7 Dandy Dr, Cos Cob, CT 06807-2204 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Elizabeth Virginia-hartman | 92 Hix Ave, Rye, NY 10580-2450 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
Elizabeth C Dubovsky | 117 N Jay St, Middleburg, VA 20117-2661 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
Gary Leeds | 16 Elizabeth Ln, Riverside, CT 06878-1302 | Physician/surgeon | ~ |
Elizabeth Kao | 4 Edenville Rd, Warwick, NY 10990-2419 | Physician/surgeon | 2017-10-01 ~ 2018-09-30 |
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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).