SHAWN RUSSELL MD
Controlled Substance Registration for Practitioner


Address: 28 Lincoln Dr, New Canaan, CT 06840

SHAWN RUSSELL MD (Credential# 175312) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 1999. The license expiration date date is February 28, 2000. The license status is INACTIVE.

Business Overview

SHAWN RUSSELL MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0024331. The credential type is controlled substance registration for practitioner. The effective date is March 1, 1999. The expiration date is February 28, 2000. The business address is 28 Lincoln Dr, New Canaan, CT 06840. The current status is inactive.

Basic Information

Licensee Name SHAWN RUSSELL MD
Credential ID 175312
Credential Number CSP.0024331
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 28 Lincoln Dr
New Canaan
CT 06840
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 1999-03-01
Expiration Date 2000-02-28
Refresh Date 2009-01-26

Office Location

Street Address 28 LINCOLN DR
City NEW CANAAN
State CT
Zip Code 06840

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Competitor

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City NEW CANAAN
Zip Code 06840
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW CANAAN

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Dataset Information

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).

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