ROBERT P FORNSHELL (Credential# 539313) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is APPROVED.
ROBERT P FORNSHELL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.008958. The credential type is physician/surgeon. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 113b Stonecrest Rd, Ridgefield, CT 06877-2540. The current status is approved.
| Licensee Name | ROBERT P FORNSHELL |
| Credential ID | 539313 |
| Credential Number | 1.008958 |
| Credential Type | Physician/Surgeon |
| Business Address |
113b Stonecrest Rd Ridgefield CT 06877-2540 |
| Business Type | INDIVIDUAL |
| Status | APPROVED - CURRENT |
| Active | 1 |
| Issue Date | 1958-05-15 |
| Effective Date | 2020-08-01 |
| Expiration Date | 2021-07-31 |
| Refresh Date | 2020-06-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 151113 | CSP.0005352 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1996-09-01 | 2017-03-01 - 2019-02-28 | LAPSED |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robert P Fornshell | 113 Stonecrest Rd, Ridgefield, CT 06877-2540 | Emergency Medical Technician | ~ |
| Street Address | 113B STONECREST RD |
| City | RIDGEFIELD |
| State | CT |
| Zip Code | 06877-2540 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robert P Fornshell | 113 Stonecrest Rd, Ridgefield, CT 06877-2540 | Emergency Medical Technician | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kathleen Morrin | 169 Nod Road, Ridgefield, CT 06877 | Radiographer | 2020-09-01 ~ 2021-08-31 |
| Elena Yakimova | 8 Lawson Lane, Ridgefield, CT 06877 | Dental Hygienist | 2020-07-01 ~ 2021-06-30 |
| Jasmine Gannalo | 35 Clearview Dr, Ridgefield, CT 06877 | Esthetician | 2020-06-26 ~ 2022-06-30 |
| Nicole A Van Alstyne | 105 Stonecrest Road, Ridgefield, CT 06877 | Real Estate Salesperson | ~ |
| Andrea A Delange · Ledina | 5 Copper Beech Lane, Ridgefield, CT 06877 | Physical Therapist | 2020-09-01 ~ 2021-08-31 |
| Mitchell O Hubsher | 77 Chestnut Hill Road, Ridgefield, CT 06877 | Naturopathic Physician | 2020-07-01 ~ 2021-06-30 |
| Milillo Farms | 424 R Main St, Ridgefield, CT 06877 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Marie G Donofrio | 36 Woodlawn Dr, Ridgefield, CT 06877 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Jennifer M Kinford | 40 Woodland Way, Ridgefield, CT 06877 | Esthetician | ~ |
| Lauren Elizabeth Pambianchi | 49 11 Levels Road, Ridgefield, CT 06877 | Registered Nurse | ~ |
| Find all Licenses in zip 06877 | |||
| City | RIDGEFIELD |
| Zip Code | 06877 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + RIDGEFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brent Robert Jacobson | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Mary Jo Fornshell | 38 Orchard Hill Rd, Westport, CT 06880-2926 | Home Improvement Salesperson | 2020-06-04 ~ 2020-11-30 |
| Robert J Gionfriddo | CT | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Robert Koenekoop | Westmount, QC H37 2W4 | Physician/surgeon | 2007-10-05 ~ 2008-10-31 |
| Robert Lee Gore | 79 Richmond St, Dorchester, MA 02124-5873 | Physician/surgeon | ~ |
| Robert Mittman | 230-26 53 Ave, Bayside, NY 11364 | Physician/surgeon | 2016-03-01 ~ 2017-02-28 |
| Robert Y Chang Md | 35 Elm St, New Haven, CT 06510 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Robert C Alvis Md | Po Box 194, Thornwood, NY 10594 | Physician/surgeon | 2019-02-01 ~ 2020-01-31 |
| Robert Nordness | 141 Elm St, Stonington, CT 06378-1163 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Robert B Sirkin | Po Box 903, Grantham, NH 03753 | Physician/surgeon | 1995-08-18 ~ 1996-05-31 |
Please comment or provide details below to improve the information on ROBERT P FORNSHELL.
| 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).