ANDREW E WAKEFIELD MD (Credential# 555207) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
ANDREW E WAKEFIELD MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.037617. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 360 Bloomfield Avenue, Windsor, CT 06095. The current status is active.
| Licensee Name | ANDREW E WAKEFIELD MD |
| Credential ID | 555207 |
| Credential Number | 1.037617 |
| Credential Type | Physician/Surgeon |
| Business Address |
360 Bloomfield Avenue Windsor CT 06095 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-03-26 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-02-07 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 213021 | CSP.0028193 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-05-03 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 360 BLOOMFIELD AVENUE |
| City | WINDSOR |
| State | CT |
| Zip Code | 06095 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cherene M Scott | 123 Clover St, Windsor, CT 06095 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Marianne Lauri | 9 Mohawk Circle, Windsor, CT 06095 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Elaine R Birthwright Rowe | 71 Ford Road, Windsor, CT 06095 | Real Estate Salesperson | ~ |
| Annmarie Blair-atkinson | 19 Hope Circle, Windsor, CT 06095 | Medication Administration Certification | 2020-05-23 ~ 2022-05-22 |
| Cristina Valente | 39 Lochview Dr, Windsor, CT 06095 | Master's Level Social Worker | 2020-07-01 ~ 2021-06-30 |
| Bridget C Tran | 500 Huckleberry Rd, Windsor, CT 06095 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Kelli Price | 15 Berrios Hill Road, Windsor, CT 06095 | Professional Counselor | 2020-09-01 ~ 2021-08-31 |
| Yalanda Squirewell | 217 Willowcrest Drive, Windsor, CT 06095 | Real Estate Salesperson | ~ |
| Omason O Modeste | 30 Lepage Rd, Windsor, CT 06095 | Emergency Medical Technician | 2017-04-06 ~ 2020-06-30 |
| Mark E Allen | 372 Broad St, Windsor, CT 06095 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06095 | |||
| City | WINDSOR |
| Zip Code | 06095 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + WINDSOR |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrew J Dowd | 70 Kenyon Ave Unit 325, Wakefield, RI 02879-4253 | Physician/surgeon | 2015-07-01 ~ 2015-12-29 |
| Patricia A Devine | 15 Lincoln St # 342, Wakefield, MA 01880-3001 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Susan E Taft | 41 Coddington Way, Wakefield, RI 02879 | Physician/surgeon | 2008-04-01 ~ 2009-04-30 |
| Rana S. Sahni | 95 Kenyon Ave, Wakefield, RI 02879 | Physician/surgeon | 1984-08-16 ~ 1985-05-31 |
| Carlo G Brogna | 33 Dockray St, Wakefield, RI 02879 | Physician/surgeon | 2002-07-26 ~ 2003-05-31 |
| Daniel Francis Flynn | 16 Park St, Wakefield, MA 01880-5011 | Physician/surgeon | 2019-09-03 ~ 2020-09-30 |
| Joseph David Heineman | 70 Kenyon Avenue, Wakefield, RI 02879 | Physician/surgeon | ~ |
| Michael A Peszke | 2 Land and Sea Drive, Wakefield, RI 02879 | Physician/surgeon | 2013-01-01 ~ 2013-12-31 |
| John Philip Heffernan | 70 Kenyon Avenue, Wakefield, RI 02879 | Physician/surgeon | ~ |
| Brett Lawrence Arron | 52 Lake St, Wakefield, RI 02879-4116 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
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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).