LEE E EDSTROM (Credential# 541203) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 23, 2001. The license expiration date date is July 31, 2002. The license status is INACTIVE.
LEE E EDSTROM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.014674. The credential type is physician/surgeon. The effective date is July 23, 2001. The expiration date is July 31, 2002. The business address is Medical Office Ctr, Providence, RI 02905. The current status is inactive.
| Licensee Name | LEE E EDSTROM |
| Credential ID | 541203 |
| Credential Number | 1.014674 |
| Credential Type | Physician/Surgeon |
| Business Address |
Medical Office Ctr Providence RI 02905 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1970-10-19 |
| Effective Date | 2001-07-23 |
| Expiration Date | 2002-07-31 |
| Refresh Date | 2009-07-08 |
| Street Address | MEDICAL OFFICE CTR |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02905 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Martha L Werenfels | 66 Fort Avenue, Cranston, RI 02905 | Architect | 2020-08-01 ~ 2021-07-31 |
| Deborah L Myers | 101 Dudley Street, Providence, RI 02905 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Peter M Scotti | 18 Hudson Place, Cranston, RI 02905 | Certified General Real Estate Appraiser | 2020-05-01 ~ 2021-04-30 |
| Paul H Dyer | 19 Henry St, Cranston, RI 02905 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Tammie W Sutton | 43 Colfax St., Providence, RI 02905 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Mark A Caruso | 9 Rhodes Avenue, Cranston, RI 02905 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Stephen Paul Tippe | 1972 Broad Street, Cranston, RI 02905 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Michael T Parker | 139 Babcock Street, Providence, RI 02905 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Jacquelyn Nicole Fellows | 198 Armington St Apt 8, Cranston, RI 02905 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| David Duarte | 48 Harbor View Terrace, Stonington, CT 02905 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Find all Licenses in zip 02905 | |||
| City | PROVIDENCE |
| Zip Code | 02905 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + PROVIDENCE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Gretchen E Edstrom · Edstrom | 23 Paula Lane, Waterford, CT 06385 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Danielle Justine Tarbell | 133 Edstrom Road, Marlborough, CT 06447 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Sarah E Brown | 112 Edstrom Rd, Marlborough, CT 06447-1339 | Radiographer | 2020-06-01 ~ 2021-05-31 |
| Jamie L Stewart | 112 Edstrom Rd, Marlborough, CT 06447-1339 | Radiographer | 2020-01-01 ~ 2020-12-31 |
| Bradley W Platt | 21 Edstrom Rd, Marlborough, CT 06447-1337 | Paramedic | 2012-03-15 ~ 2012-12-31 |
| Rylie N Szolomayer | 120 Edstrom Rd, Marlborough, CT 06447-1339 | Emergency Medical Technician | ~ |
| Jo-ellen D Beam | 120 Edstrom Rd, Marlborough, CT 06447 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Justin Martin | 118 Edstrom Rd, Marlborough, CT 06447-1339 | Engineer-in-training | 2018-05-30 ~ 2028-05-30 |
| Paul J Giansanti | 46-g Edstrom Road, Marlborough, CT 06447 | Barber | 2013-01-01 ~ 2014-06-14 |
| Amy A Edstrom | P O Box 2162, Vero Beach, FL 32961 | Registered Nurse | 1993-04-23 ~ 1994-03-31 |
Please comment or provide details below to improve the information on LEE E EDSTROM.
| 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).