ADAM W SHEN
Controlled Substance Registration for Practitioner


Address: 304 Community Drive Apt 1r, Manhasset, NY 11030

ADAM W SHEN (Credential# 1425212) 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 INACTIVE.

Business Overview

ADAM W SHEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0065520. 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 304 Community Drive Apt 1r, Manhasset, NY 11030. The current status is inactive.

Basic Information

Licensee Name ADAM W SHEN
Credential ID 1425212
Credential Number CSP.0065520
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 304 Community Drive Apt 1r
Manhasset
NY 11030
Business Type INDIVIDUAL
Status INACTIVE - LACK OF ACTIVE MEDICAL LICENSE
Issue Date 2017-05-24
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2020-04-24

Other licenses

ID Credential Code Credential Type Issue Term Status
1488833 1.058228-RES Resident Physician 2017-07-01 2017-07-01 - 2019-07-31 INACTIVE

Office Location

Street Address 304 COMMUNITY DRIVE APT 1R
City MANHASSET
State NY
Zip Code 11030

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City MANHASSET
Zip Code 11030
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MANHASSET

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Dataset Information

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).

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