PHILLIP M PETERSON (Credential# 765124) is licensed (Nursing Home Administrator) with Connecticut Department of Consumer Protection. The license effective date is November 13, 1997. The license expiration date date is January 31, 1999. The license status is INACTIVE.
PHILLIP M PETERSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #36.000846. The credential type is nursing home administrator. The effective date is November 13, 1997. The expiration date is January 31, 1999. The business address is 2783 Cottonwood La, Pensacola, FL 32514. The current status is inactive.
| Licensee Name | PHILLIP M PETERSON |
| Credential ID | 765124 |
| Credential Number | 36.000846 |
| Credential Type | Nursing Home Administrator |
| Business Address |
2783 Cottonwood La Pensacola FL 32514 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1982-10-08 |
| Effective Date | 1997-11-13 |
| Expiration Date | 1999-01-31 |
| Refresh Date | 2009-07-08 |
| Street Address | 2783 COTTONWOOD LA |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32514 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Melissa A Reed | 8325 Harbour Square Drive, Pensacola, FL 32514 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Elizabeth L Merriweather | 1765 E. Nine Mile Rd Suite 1 #221, Pensacola, FL 32514 | Licensed Clinical Social Worker | 2020-01-01 ~ 2020-12-31 |
| Gail F Chambers | 905 Crystal Creek Cr, Pensacola, FL 32514 | Registered Nurse | 2014-07-01 ~ 2015-06-30 |
| Elise Treff Gordon | 9400 University Pkwy, Pensacola, FL 32514 | Physician/surgeon | ~ |
| Thomas B Watson IIi | 3010 East Kingsfield Rd, Pensacola, FL 32514 | Professional Engineer | 2002-07-16 ~ 2003-01-31 |
| Harish K Malhotra | 8331 N. Davis Highway, Pensacola, FL 32514 | Physician/surgeon | 2011-10-01 ~ 2012-09-30 |
| Joanne H Neri | 2764 Belle Meadow, Pensacola, FL 32514 | Registered Nurse | 1993-05-25 ~ 1994-05-31 |
| John Carrozzela | 8333 North Davis Highway, Pensacola, FL 32514 | Physician/surgeon | 1998-02-05 ~ 1988-10-31 |
| John H Clark Aprn | 5049 Avocet Ln, Pensacola, FL 32514 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| William H Perling | 9700 Bowman Ave, Pensacola, FL 32514 | Heating, Piping & Cooling Limited Journeyperson | ~ |
| Find all Licenses in zip 32514 | |||
| City | PENSACOLA |
| Zip Code | 32514 |
| License Type | Nursing Home Administrator |
| License Type + County | Nursing Home Administrator + PENSACOLA |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Phillip A Krakowiak Sr | 406 Second Ave., West Haven, CT 06516 | Nursing Home Administrator | 2010-08-01 ~ 2012-07-31 |
| Courtney L Peterson | 166 Ledgewood Rd Apt 410, Groton, CT 06340-6622 | Nursing Home Administrator | 2019-10-02 ~ 2021-09-30 |
| Eleanor Peterson · Bond | 380-16 Meridian St, Groton, CT 06340 | Nursing Home Administrator | 2000-05-03 ~ 2001-04-30 |
| Patrick W Lyons | CT | Nursing Home Administrator | ~ |
| Michael E Bell | CT | Nursing Home Administrator | ~ |
| Richard F Ide | P.o. Box 73, Ashford, CT 06278 | Nursing Home Administrator | 2004-06-07 ~ 2006-04-30 |
| Gabriel N Tanwani | Po Box 631, Randallstown, MD 21133-0631 | Nursing Home Administrator | ~ |
| Arunava De | 350 Cobbler Ln, Southbury, CT 06488-4641 | Nursing Home Administrator | ~ |
| Kimberly D Brown | Apt 303, Groton, CT 06340 | Nursing Home Administrator | ~ |
| Katie M Lee | 11 Englewood Dr, Manchester, CT 06042-2738 | Nursing Home Administrator | ~ |
Please comment or provide details below to improve the information on PHILLIP M PETERSON.
| 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).