SHANE OLIVER JORDAN (Credential# 1527594) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
SHANE OLIVER JORDAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.004185. The credential type is physician assistant. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 245 5th Ave, New York, NY 10016. The current status is active.
| Licensee Name | SHANE OLIVER JORDAN |
| Credential ID | 1527594 |
| Credential Number | 23.004185 |
| Credential Type | Physician Assistant |
| Business Address |
245 5th Ave New York NY 10016 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-08-09 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-12-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1591883 | CSP.0069289 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-08-10 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 245 5th Ave |
| City | NEW YORK |
| State | NY |
| Zip Code | 10016 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mariella Katherine Castro | 245 5th Ave, New York, NY 10016 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Annelie Christina Roding | 245 5th Ave, New York, NY 10016 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Stephanie Nicole Gregory | 245 5th Ave, New York, NY 10016 | Advanced Practice Registered Nurse | 2020-05-27 ~ 2020-12-31 |
| Brett Leslie Deutscher | 245 5th Ave, New York, NY 10016 | Registered Nurse | 2020-03-31 ~ 2020-12-31 |
| Morgan Alexandra Tate | 245 5th Ave, New York, NY 10016 | Physician Assistant | 2020-04-23 ~ 2020-10-31 |
| Anna Kuzmenko | 245 5th Ave, New York, NY 10016 | Professional Counselor | 2020-02-28 ~ 2020-10-31 |
| Brendan James Sullivan | 245 5th Ave, New York, NY 10016 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
| Tara Michelle Laforge | 245 5th Ave, New York, NY 10016 | Physician Assistant | ~ |
| Ashley Lauren Pearson | 245 5th Ave, New York, NY 10016 | Professional Counselor | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Terri Michelle Parkin | 245 5th Avenue, New York, NY 10016 | Registered Nurse | ~ |
| Robert A Stern | One Park Avenue, New York, NY 10016 | Architect | 2020-08-01 ~ 2021-07-31 |
| Gerard Epelbaum Dds | 30 East 40th St #906, New York, NY 10016 | Dentist | 2020-04-01 ~ 2021-03-31 |
| Action Without Borders, Inc | 389 Fifth Avenue, 9th Floor, New York, NY 10016 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| A James Tinson | 10 E 40th Street, New York, NY 10016 | Architect | 2020-08-01 ~ 2021-07-31 |
| Melinda J Parsons | 11 East 36th Street, New York, NY 10016 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Daniel Gorman | 145 E 27th Street, New York, NY 10016 | Master's Level Social Worker - Temporary Permit | 2020-06-16 ~ 2020-09-13 |
| Steven Issley | 545 First Avenue, Suite 6g, New York, NY 10016 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Jennifer Stewart Brinton | 155 E 38th St, New York, NY 10016 | Registered Nurse | ~ |
| Steven Andrew Roberts | 300 East 33rd Street, New York, NY 10016 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 10016 | |||
| City | NEW YORK |
| Zip Code | 10016 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + NEW YORK |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Shane Jordan | 304 Winter Street, Norwell, MA 02061 | Physician Assistant | 2019-08-01 ~ 2020-07-31 |
| Jordan and Shane LLC | 75 Hastings Ln, Stamford, CT 06905-2902 | Home Improvement Contractor | ~ |
| Shane C Morgan | 296 Wilbert Way, North Kingstown, RI 02852-7317 | Physician Assistant | 2019-05-01 ~ 2020-04-30 |
| Oliver M Betancourt | 32 Beatrice Ave, Syosset, NY 11791-4005 | Physician Assistant | ~ |
| Melissa A Miller | 174 Krystyna Lane, Jordan, NY 13080 | Physician Assistant | 2005-07-01 ~ 2006-07-31 |
| Jordan Ruth Day | 27759 Jakes Drive, Cataldo, ID 83810 | Physician Assistant | 2016-09-30 ~ 2017-05-31 |
| Jordan M Silidker | 1909 Long Hill Rd, Guilford, CT 06437-1303 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Shane J Smith | 61 Jordan Ln, Middletown, NY 10940-1605 | Tv & Radio Limited Dish Antenna Technician | ~ |
| Mr Shane's Ice Cream · Mr Shane's Homemade Parlour Ice Cream Inc | 409 Main St, Ridgefield, CT 06877 | Frozen Dessert Wholesaler | 2003-08-15 ~ 2003-12-31 |
| Oliver House | 342 Oliver Road, New Haven, CT 06511 | Community Living Arrangement | 2018-10-01 ~ 2020-09-30 |
Please comment or provide details below to improve the information on SHANE OLIVER JORDAN.
| 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).