JOHN W BOARDMAN (Credential# 400539) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.
JOHN W BOARDMAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0037259. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2011. The expiration date is February 28, 2013. The business address is Po Box 1619, Coeur D Alene, ID 83816-1619. The current status is inactive.
| Licensee Name | JOHN W BOARDMAN |
| Credential ID | 400539 |
| Credential Number | CSP.0037259 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
Po Box 1619 Coeur D Alene ID 83816-1619 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2005-04-08 |
| Effective Date | 2011-03-01 |
| Expiration Date | 2013-02-28 |
| Refresh Date | 2014-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 559529 | 1.041946 | Physician/Surgeon | 2003-10-28 | 2003-10-28 - 2012-04-30 | PENDING |
| Street Address | PO BOX 1619 |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83816-1619 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Suzanne Lei Aquino | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| Shree Jayendra Shah | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| Dishant Girish Shah | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| William Joseph Rusnak | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| Patrick Joseph Burke | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| Syed Ali Akbar | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| Anthony Joseph Willis | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Samuel William S'doia | P.o. 1619, Coeur D'alene, ID 83816 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Troy A Belle | Direct Radiology, Coeur D'alene, ID 83816 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Lee J Secrist Md | Po Box 2127, Coeur D Alene, ID 83816 | Physician/surgeon | 2013-03-01 ~ 2014-02-28 |
| John Robert Blackwell | P.o. Box 1619, Coeur D'alene, ID 83816 | Physician/surgeon | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Santiago Jimenez | 1620 Northwest Blvd Ste 202, Coeur D Alene, ID 83814-2488 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Michelle C Meyer | 1509 E Coeur D Alene Ave, Coeur D Alene, ID 83814-5412 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Joanna Arcuni Carlson | 1839 N Government Way Ste B, Coeur D Alene, ID 83814-3454 | Physician/surgeon | 2019-09-04 ~ 2020-01-31 |
| Perry P Kaneriya | 1839 N Government Way, Coeur D Alene, ID 83814-3454 | Physician/surgeon | 2014-07-01 ~ 2015-06-30 |
| Jason Doonan | 833 E Mullan Ave Apt 220, Coeur D Alene, ID 83814-4027 | Paramedic | 2014-04-01 ~ 2015-03-31 |
| Lawrence D Bub Md | 601 Front Ave #400, Coeur D Alene, ID 83814 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Faisal A Sami Md | 601 Front Ave. #502, Coeur D Alene, ID 83814-2973 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Thomas B Jones Md | 601 Front Ave., #502, Coeur D Alene, ID 83814 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Rolf P Tonseth Md | C/o Virtual Radiologic, Coeur D Alene, ID 83814-5155 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Christopher J Miller Md | 601 Front Avenue, Suite 400, Coeur D Alene, ID 83814 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Find all Licenses in COEUR D ALENE | |||
| City | COEUR D ALENE |
| Zip Code | 83816 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + COEUR D ALENE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jack A Elias | Boardman 110, New Haven, CT 06520-8056 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Jonathan Bradford Thoens | 119 Withers Dr, Boardman, OH 44512-2935 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Allison Boardman | 189 Newington Rd, West Hartford, CT 06110 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| John K John Md | 706f Doctors Drive, Kinston, NC 28501 | Controlled Substance Registration for Practitioner | 2001-03-01 ~ 2002-02-28 |
| John P Salerno | P.o. Box 848, Fairfield, CT 06824-6541 | Controlled Substance Registration for Practitioner | 2019-12-19 ~ 2021-02-28 |
| John W Mah Md | 80 Seymour St, Hartford, CT 06102 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| John J Girald | Po Box 11, Newbury, NH 03255 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-01-17 |
| John J Cho | 111 E 210th St, Bronx, NY 10467-2401 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| John Delhagen Md | Po Box 772, Greenwich, CT 06836 | Controlled Substance Registration for Practitioner | 1999-03-01 ~ 2000-02-28 |
| John N Utz | 197 Norwich-new, Uncasville, CT 06382 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on JOHN W BOARDMAN.
| 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).