SHANNON MARIE KEOHANE (Credential# 1669872) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2020. The license expiration date date is August 31, 2021. The license status is ACTIVE.
SHANNON MARIE KEOHANE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.004596. The credential type is physician assistant. The effective date is September 1, 2020. The expiration date is August 31, 2021. The business address is 2655 Northwinds Pkwy, Alpharetta, GA 30009-2280. The current status is active.
| Licensee Name | SHANNON MARIE KEOHANE |
| Credential ID | 1669872 |
| Credential Number | 23.004596 |
| Credential Type | Physician Assistant |
| Business Address |
2655 Northwinds Pkwy Alpharetta GA 30009-2280 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-09-18 |
| Effective Date | 2020-09-01 |
| Expiration Date | 2021-08-31 |
| Refresh Date | 2020-06-19 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1692455 | CSP.0072447 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-09-18 | 2019-09-18 - 2021-02-28 | ACTIVE |
| Street Address | 2655 NORTHWINDS PKWY |
| City | ALPHARETTA |
| State | GA |
| Zip Code | 30009-2280 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Faisal Ahmad | 2655 Northwinds Pkwy, Alpharetta, GA 30009-2280 | Controlled Substance Registration for Practitioner | 2020-02-26 ~ 2021-02-28 |
| Winnie Tsao | 2655 Northwinds Pkwy, Alpharetta, GA 30009-2280 | Controlled Substance Registration for Practitioner | 2019-08-12 ~ 2021-02-28 |
| Julio Alberto Riascos | 2655 Northwinds Pkwy, Alpharetta, GA 30009-2280 | Controlled Substance Registration for Practitioner | 2019-03-11 ~ 2021-02-28 |
| Marian Catherine Malone | 2655 Northwinds Pkwy, Alpharetta, GA 30009-2280 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Taiye A Ogundipe | 2655 Northwinds Pkwy, Alpharetta, GA 30009-2280 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Barbara Robinson | 2655 Northwinds Pkwy, Alpharetta, GA 30009 | Physician/surgeon | 2019-12-02 ~ 2020-12-31 |
| Johnathan Heath Thompson | 2655 Northwinds Pkwy, Alpharetta, GA 30009-2280 | Physician/surgeon | 2018-06-08 ~ 2019-06-30 |
| Jorge Carrera | 2655 Northwinds Pkwy, Alpharetta, GA 30009-2280 | Controlled Substance Registration for Practitioner | 2016-08-27 ~ 2017-02-28 |
| Georges Jean-pierre | 2655 Northwinds Pkwy, Alpharetta, GA 30009-2280 | Physician/surgeon | ~ |
| Maria Victoria Recio Restrepo | 2655 Northwinds Pkwy, Alpharetta, GA 30009-2280 | Physician/surgeon | ~ |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Karim Mohammad Rahimi | 2655 Northwinds Parkway, Alpharetta, GA 30009 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Nancy Covington | 11390 Old Roswell Road, Alpharetta, GA 30009 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Reza S Jenabzadeh | 8000 Avalon Blvd, Suite 700, Alpharetta, GA 30009 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Romulo Lakip Jr | 7905 Westside Parkway Ste 100, Alpharetta, GA 30009 | Professional Engineer | 2018-02-01 ~ 2019-01-31 |
| Sarah C Carver | 2112 Woodland Lane, Alpharetta, GA 30009 | Occupational Therapist | 2013-08-01 ~ 2015-07-31 |
| Truc Thi Minh Nguyen | 2655 Northwinds Parkway, Alpharetta, GA 30009 | Physician/surgeon | 2019-11-04 ~ 2020-10-31 |
| Allen Berkowitz | 2655 Northwinds Parkway, Alpharetta, GA 30009 | Physician/surgeon | ~ |
| Susan E Shea | 378 Meadow Dr, Alpharetta, GA 30009-1559 | Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Eric R Zinn | 111 Spur Ln, Alpharetta, GA 30009-1808 | Lottery Or Otb Service Provider Management | 2019-06-20 ~ 2020-08-31 |
| Laura E Michael | 11390 Old Roswell Rd Ste 100, Alpharetta, GA 30009-2058 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Find all Licenses in zip 30009 | |||
| City | ALPHARETTA |
| Zip Code | 30009 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + ALPHARETTA |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Shannon C Berger | 9 Colony Dr, Winsted, CT 06098 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Shannon Brigham | 41 Stanie Brae Dr, Watchung, NJ 07069-6231 | Physician Assistant | ~ |
| Shannon Lambert | 96 Corey Colonial, Agawam, MA 01001-2749 | Physician Assistant | 2011-12-01 ~ 2012-11-30 |
| Shannon Carroll | 184 Summer St Apt 1610, Stamford, CT 06901-2352 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Shannon C Blake Pa | 1217 Tidalwalk Dr, Wilmington, NC 28409 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Shannon Gorton | 2800 Main St, Bridgeport, CT 06606-4201 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Mary F Keohane | 168 Middle Beach Rd, Madison, CT 06516 | Physician/surgeon | 2004-08-16 ~ 2005-05-31 |
| Shannon Maxon Pa | 33 Cosey Beach Ave, East Haven, CT 06512-4905 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Erin Kate Shannon | 3240 Monroe Ave, Rochester, NY 14618 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Dominic E Vozzella | 19 Marie St, Milford, CT 06460-7632 | Physician Assistant | ~ |
Please comment or provide details below to improve the information on SHANNON MARIE KEOHANE.
| 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).