RYAN THOMAS PETERSON (Credential# 1490906) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2016. The license expiration date date is June 30, 2021. The license status is ACTIVE.
RYAN THOMAS PETERSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.059008-RES. The credential type is resident physician. The effective date is July 1, 2016. The expiration date is June 30, 2021. The business address is 720 Harrison Ave, Dob 9th Floor, Rm 915, Boston, MA 02118. The current status is active.
Licensee Name | RYAN THOMAS PETERSON |
Credential ID | 1490906 |
Credential Number | 1.059008-RES |
Credential Type | Resident Physician |
Credential SubCategory | RES |
Business Address |
720 Harrison Ave, Dob 9th Floor, Rm 915 Boston MA 02118 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2016-07-01 |
Effective Date | 2016-07-01 |
Expiration Date | 2021-06-30 |
Refresh Date | 2020-05-27 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1356006 | CSP.0062830 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-05-24 | 2017-03-01 - 2019-02-28 | LAPSED |
1353083 | 1.055295 | Physician/Surgeon | 2016-05-23 | 2017-05-01 - 2018-04-30 | INACTIVE |
Street Address | 720 Harrison Ave, DOB 9th floor, Rm 915 |
City | Boston |
State | MA |
Zip Code | 02118 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Martin J Batt · Isgenuity LLC | 500 Harrison Avenue, Suite 5f, Boston, MA 02118 | Architect | 2020-08-01 ~ 2021-07-31 |
Benjamin Ravelson | 675 Tremont Street, #6, Boston, MA 02118 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Samuel M. Hauslaib | 673 Tremont Street, Apartment 8, Boston, MA 02118 | Behavior Analyst | 2020-06-01 ~ 2021-05-31 |
Steven Arthur Faerstain | 820 Harrison Avenue, Boston, MA 02118 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
Samuel M Koonce | 580 Tremont Street, Boston, MA 02118 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
George C Ballantyne | 22 Worcester Square, Boston, MA 02118 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
William Kendall Bache | 300 Harrison Ave, Boston, MA 02118 | Physician/surgeon | ~ |
Threehill Capital Partners, LLC | 212 West Springfield Street, Boston, MA 02118 | Securities - Exemptions | 2020-02-24 ~ |
Flint Program Incorporated | 574 Massachusetts Avenue Apt B 3, Boston, MA 02118 | Public Charity | 2020-06-01 ~ 2021-05-31 |
William Huber | 433 Harrison Avenue, Boston, MA 02118 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
Find all Licenses in zip 02118 |
City | Boston |
Zip Code | 02118 |
License Type | Resident Physician |
License Type + County | Resident Physician + Boston |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Danielle M Peterson | 22 Gold St Apt 116, New Haven, CT 06519-1602 | Resident Physician | 2019-08-01 ~ 2021-08-01 |
Shane Peterson | 80 Seymour St, Po Box 5037, Hartford, CT 06102-5037 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
Ryan D. Fillmore | 20 York St, New Haven, CT 06510 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
Ryan P Duggan | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
Brienne Ryan | 1 Hospital Plz, Stamford, CT 06902-3602 | Resident Physician | 2019-07-01 ~ 2024-06-30 |
Ryan J Cole | 40 Devonwood Dr, Waterbury, CT 06708-2302 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
Ryan Alexander | 130 Division St, Derby, CT 06418 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
Ryan Riordan | 23 S Jefferson St, Batavia, IL 60510-2419 | Resident Physician Assistant | 2020-05-26 ~ 2021-12-31 |
Ryan S O'dell | 300 George Street, New Haven, CT 06511 | Resident Physician | 2017-06-12 ~ 2021-06-30 |
Ryan J Slovak | 6 Round Hill Rd, Shelton, CT 06484-1688 | Resident Physician | 2020-06-11 ~ 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).