MARTHA STEPHENS MD (Credential# 548149) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
MARTHA STEPHENS MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.029985. The credential type is physician/surgeon. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 11 Cambridge Court East, Old Saybrook, CT 06475. The current status is active.
Licensee Name | MARTHA STEPHENS MD |
Credential ID | 548149 |
Credential Number | 1.029985 |
Credential Type | Physician/Surgeon |
Business Address |
11 Cambridge Court East Old Saybrook CT 06475 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 1989-05-26 |
Effective Date | 2020-03-01 |
Expiration Date | 2021-02-28 |
Refresh Date | 2020-02-07 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
159325 | CSP.0017216 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2017-03-01 - 2019-02-28 | LAPSED |
Street Address | 11 CAMBRIDGE COURT EAST |
City | OLD SAYBROOK |
State | CT |
Zip Code | 06475 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Koubao Wang | 119 Old Boston Post Rd, Old Saybrook, CT 06475 | Nail Technician | 2020-06-26 ~ 2022-05-31 |
Houng Woo Kim | 103 Salmon Brook Dr Apt C, Glastonbury, CT 06475 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-06-30 |
Hull Harbor Inc | Bridge St, Old Saybrook, CT 06475 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Nancy J Norrie-murphy | 18 Fenwood Place, Old Saybrook, CT 06475 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
Fromage Fine Foods & Coffees | 873 Boston Post Rd, Old Saybrook, CT 06475 | Bakery | 2020-07-01 ~ 2021-06-30 |
Sarah E Grandsire | 5 Ridge Drive South, Old Saybrook, CT 06475 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
James A Carr | 310 Watrous Point Rd, Old Saybrook, CT 06475 | Architect | 2020-08-01 ~ 2021-07-31 |
Peng Jiang | 137 Mian St, Old Saybrook, CT 06475 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
Camille A Brodeur | 90 North Cove Rd, Old Saybrook, CT 06475 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
Emily Marie Peluso | 27 Briarwood Drive, Old Saybrook, CT 06475 | Advanced Practice Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Find all Licenses in zip 06475 |
City | OLD SAYBROOK |
Zip Code | 06475 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + OLD SAYBROOK |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Ralph R Stephens Jr | 530 Pembroke Ave, Norfolk, VA 23507 | Physician/surgeon | 1995-12-22 ~ 1996-12-31 |
Daniel Joshua Stephens | 20 Swarthmore Rd, Scarsdale, NY 10583 | Physician/surgeon | ~ |
James Stephens Md | 42 Irving Ave, Providence, RI 02906 | Physician/surgeon | 2003-04-15 ~ 2004-01-31 |
Polly L Stephens | 113 Middlebury Road, Watertown, CT 06795 | Physician/surgeon | 1998-03-23 ~ 1999-05-31 |
Evelyn Stephens | 12 Old Hill Farms Rd, Westport, CT 06880-3034 | Physician/surgeon | 2020-06-18 ~ 2020-12-31 |
Lora A Stephens Do | 20 North Cove Road, Old Saybrook, CT 06475 | Physician/surgeon | 2016-08-01 ~ 2017-07-31 |
David King Stephens | 15 York St, Lci 716e, New Haven, CT 06511 | Physician/surgeon | 2020-06-17 ~ 2021-05-31 |
Natalie G Stephens | 832 Hopewell Road, South Glastonbury, CT 06073 | Physician/surgeon | 1996-05-23 ~ 1997-06-30 |
Martha Buitrago Md | 36 Lincoln St, New Haven, CT 06511 | Physician/surgeon | 2002-01-24 ~ 2003-02-28 |
Martha Praught | 131 Birch St, Roslindale, MA 02131-3431 | Physician/surgeon | 1987-03-13 ~ 1992-03-31 |
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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).