MICHAEL WALLACE SENTOME (Credential# 1617076) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
MICHAEL WALLACE SENTOME is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.062367. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344. The current status is active.
| Licensee Name | MICHAEL WALLACE SENTOME |
| Credential ID | 1617076 |
| Credential Number | 1.062367 |
| Credential Type | Physician/Surgeon |
| Business Address |
11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-02-19 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-03-18 |
| Street Address | 11995 Singletree Lane, Suite 500 |
| City | Eden Prairie |
| State | MN |
| Zip Code | 55344 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kay Denise Spong Lozano | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Cynthia L Tortorelli | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Barbara M Mccorvey | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Duane Charles Wilson | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Kenton Edward Kagy | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Mark A Ziemba | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2019-12-03 ~ 2020-04-30 |
| Jamie Alexandra Aminsharifi | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Phoebe H Dann Md | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2017-10-01 ~ 2018-09-30 |
| Adina Sonners Md | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2012-10-01 ~ 2013-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Donald T Nicell | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Neuroone Medical Technologies Corp | 7599 Anagram Dr, Eden Prairie, MN 55344 | Securities - Exemptions | 2020-05-15 ~ |
| Robert Edward Stone | 11995 Singletree Lane, Ste 500, Eden Prairie, MN 55344 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Daniel James Tangert | 6400 Fallbrook Rd., Eden Prairie, MN 55344 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Dmitry Bolkhovets | 11995 Singletree Ln, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Zinpro | 104000 Vikings Drive, Suite 240, Eden Prairie, MN 55344 | Commercial Feed | 2020-03-05 ~ 2020-12-31 |
| Stephanie Denise Johnson | 8423 Cortland Rd, Eden Prairie, MN 55344 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Ashley Nicole Ingram | 11000 Optum Circle, Eden Prairie, MN 55344 | Registered Nurse | 2020-01-16 ~ 2020-08-31 |
| Colleen M Steven | 13900 Chestnut Drive # 208, Eden Prarie, MN 55344 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Rebecca Dipofi Rogers | 13625 Technology Dr, Eden Prairie, MN 55344 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Find all Licenses in zip 55344 | |||
| City | Eden Prairie |
| Zip Code | 55344 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Eden Prairie |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael Lloyd Wallace | 875 Greentree Rd, Pittsburgh, PA 15220-3508 | Physician/surgeon | ~ |
| Christopher A Wallace | 6 Charlotte Ct, Avon, CT 06001-2257 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Max L Wallace Jr | 383 Rockwood Drive, Southington, CT 06489 | Physician/surgeon | 2017-09-01 ~ 2018-08-31 |
| Ellen C Wallace | 25 Stearns Rd, Watertown, MA 02172 | Physician/surgeon | 1994-11-02 ~ 1995-12-31 |
| Keri A Wallace Md | Ct Pediatrics At Chc, Hartford, CT 06106 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Edward P Wallace Md | 285 Broad St, Meriden, CT 06450 | Physician/surgeon | 1999-02-11 ~ 2000-02-29 |
| Daniel Wallace Dahl | 40 Prospect Ave, Norwalk, CT 06850 | Physician/surgeon | 2018-01-01 ~ 2018-12-31 |
| Kathleen A Wallace | 8 Springbrook Lane, Simsbury, CT 06070 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Jan D Wallace | 1501 Turpin Lake Rd, Poolville, TX 76487-3245 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| John R Iacovino Md | 149 Legacy Woods Dr, Wallace, NC 28466 | Physician/surgeon | 2004-02-26 ~ 2005-02-28 |
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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).