TRACY SHEVELL MD (Credential# 365492) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
TRACY SHEVELL MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0034782. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 30 Shelburne Rd, Stamford, CT 06902-3628. The current status is active.
| Licensee Name | TRACY SHEVELL MD |
| Credential ID | 365492 |
| Credential Number | CSP.0034782 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
30 Shelburne Rd Stamford CT 06902-3628 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2004-04-15 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 559719 | 1.042137 | Physician/Surgeon | 2004-02-10 | 2019-08-01 - 2020-07-31 | ACTIVE |
| Street Address | 30 SHELBURNE RD |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902-3628 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nicole S Feagin | 30 Shelburne Rd, Stamford, CT 06902-3628 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Randall D Grant | 30 Shelburne Rd, Stamford, CT 06902-3628 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Hebroon Obaid | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Shelley Smith Tickett | 30 Shelburne Rd, Stamford, CT 06902-3628 | Physician/surgeon | 2018-04-01 ~ 2019-03-31 |
| Michelle R Maly | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2017-04-21 ~ 2019-02-28 |
| Diana M Bernal-messinger Aprn | 30 Shelburne Rd, Stamford, CT 06902 | Controlled Substance Registration for Practitioner | 2017-04-20 ~ 2019-02-28 |
| Molly Findley | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Maureen C Burke | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Jennifer Cabral | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2015-03-23 ~ 2017-02-28 |
| Elizabeth M Rodriguez | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marcos Valerio | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-06 ~ 2021-02-28 |
| Antonia L Green | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| John F Ciannella Md | One Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sasha Cobotic | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Dmitry Meyerovich | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Arunabha Nandi | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Julianne M Wilmot | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kamal Addagatla | Department of Surgery, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Chao Guo | 59 Liberty Street, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Basil N Waoz | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Find all Licenses in zip 06902-3628 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeris Maydeli Flores | 153 Fairfield Av, Stamford, CT 06902 | Nail Technician | ~ |
| Reynaldo De La Cruz | 64 Brookside Drive, Stamford, CT 06902 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Darren J Petillo | 5 Hundley Court, Stamford, CT 06902 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Antonios Restaurant | 405 West Main St, Stamford, CT 06902 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Edward Smith | 184 Fairfield Ave., Stamford, CT 06902 | Home Improvement Contractor | ~ |
| Margaret A Dorrance | 24c Hamilton Court, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carolyn Maguire | 48 Nelson St, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Evelyne Joassin | 17 George St., Stamford, CT 06902 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Andrea Bynoe | 34 Melrose Pl, Stamford, CT 06902 | Notary Public Appointment | 1994-04-06 ~ 1999-04-30 |
| Ravi K Ahuja | 296 Westover Rd, Stamford, CT 06902 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06902 | |||
| City | STAMFORD |
| Zip Code | 06902 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + STAMFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lauren Elisabeth Marsh Shevell | 20 York Street, New Haven, CT 06510-3202 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tracy E Kim Md | 178 Linden St Apt #g-4, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2003-03-01 ~ 2004-02-28 |
| Tracy L Jones | 1 Peaceful Pl, Shelton, CT 06484-3418 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tracy S Wang Md | 109 Church St Apt 401, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Tracy G Carmellini | 101 No Plains, Wallingford, CT 06492 | Controlled Substance Registration for Practitioner | 2000-02-29 ~ 2001-02-28 |
| Tracy N. Huynh | 27 Hubinger St, New Haven, CT 06511-4034 | Controlled Substance Registration for Practitioner | 2011-06-28 ~ 2013-02-28 |
| Tracy L Macintosh | 23 Oxbow Dr, Meriden, CT 06450-6938 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Daniel W Tracy IIi | 100 Fanning Ave, Norwich, CT 06360 | Controlled Substance Registration for Practitioner | 2019-05-08 ~ 2021-02-28 |
| Tracy A Hawthorne Pa | 285 Turnpike Rd, Ashford, CT 06278-2411 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tracy L Johnson Dvm | 62 Grant Rd, Bethany, CT 06524-3063 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).