JENNIFER L GANNON (Credential# 1490696) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2013. The license expiration date date is June 30, 2021. The license status is ACTIVE.
JENNIFER L GANNON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.058798-RES. The credential type is resident physician. The effective date is July 1, 2013. The expiration date is June 30, 2021. The business address is 167 Thompson Hill Road, Portland, CT 06480. The current status is active.
| Licensee Name | JENNIFER L GANNON |
| Credential ID | 1490696 |
| Credential Number | 1.058798-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
167 Thompson Hill Road Portland CT 06480 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2013-07-01 |
| Effective Date | 2013-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-05-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 562200 | 1.044618 | Physician/Surgeon | 2006-07-26 | 2014-04-01 - 2015-03-31 | INACTIVE |
| 447129 | CSP.0040254 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-08-17 | 2013-03-01 - 2015-02-28 | INACTIVE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jennifer L Gannon | 317 Brickhope Lane, Goose Creek, SC 29445 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Street Address | 167 Thompson Hill Road |
| City | Portland |
| State | CT |
| Zip Code | 06480 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Galladex Bd T85% I 9082 | 47 Lower Main St, Portland, CT 06480 | Medical Marijuana Producer Brand Registration | 2020-06-26 ~ |
| Suzanne S O'rourke | 35 Apple Tree Lane, Portland, CT 06480 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Gui Jiang | Sunny�s Nail&spa, Portland, CT 06480 | Nail Technician | 2020-06-26 ~ 2021-12-31 |
| Kevin R Johnson | 20 Mountain Laurel Way, Portland, CT 06480 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Aaron A Adams | 138 High Street, Portland, CT 06480 | Licensed Practical Nurse | 2020-06-01 ~ 2021-05-31 |
| Amanda R. Weinberger | 270 Main St. Suite A, Portland, CT 06480 | Advanced Practice Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Karen L Cianci | 3 Myrtle Rd, Portland, CT 06480 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Joseph Bials | P.o. Box 546, Portland, CT 06480 | Sub-surface Sewage Installer | 2020-05-01 ~ 2021-04-30 |
| Olivia Jane Briggs | 6 Allen Street, Portland, CT 06480 | Radiographer | 2020-08-01 ~ 2021-07-31 |
| Donna M Dubay | 8 Penny Corner Road, Portland, CT 06480 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06480 | |||
| City | Portland |
| Zip Code | 06480 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + Portland |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jennifer A Guy | 6 Early Dr Apt K, Watervliet, NY 12189-2517 | Resident Physician | ~ |
| Jennifer Lee | 64 Robbins St, Waterbury, CT 06708-2600 | Resident Physician | 2020-12-01 ~ 2021-06-30 |
| Jennifer E Marshall | 46 Florence St, Newington, CT 06111 | Resident Physician | 2017-06-19 ~ 2021-06-18 |
| Jennifer M Kwan | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
| Jennifer A Lawson | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-06-15 ~ 2021-06-30 |
| Jennifer H Park | 20 York St, New Haven, CT 06510 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Jennifer Percy | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2017-07-01 ~ 2021-06-30 |
| Jennifer R Hewlett | 38 Volunteer Ln, Greenwich, CT 06830-5414 | Resident Physician | 2018-06-25 ~ 2021-06-28 |
| Jennifer L Hubbard | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Jennifer Jo Monacelli Cate | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
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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).