SHANNON C PETERSON (Credential# 984745) 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 ACTIVE.
SHANNON C PETERSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.049507-DO. The credential type is physician/surgeon. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 42 Sulgrave Rd, West Hartford, CT 06107. The current status is active.
| Licensee Name | SHANNON C PETERSON |
| Credential ID | 984745 |
| Credential Number | 1.049507-DO |
| Credential Type | Physician/Surgeon |
| Credential SubCategory | DO |
| Business Address |
42 Sulgrave Rd West Hartford CT 06107 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2011-02-16 |
| Effective Date | 2020-08-01 |
| Expiration Date | 2021-07-31 |
| Refresh Date | 2020-05-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 479694 | CSP.0042403 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-08-14 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 42 SULGRAVE RD |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06107 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rebecca L Stansfield | 73 Tunxis Road, West Hartford, CT 06107 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Kumari Joshi | 44 Bentwood Rd, West Hartford, CT 06107 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Laurie C Caines Md | 205 Stoner Drive, West Hartford, CT 06107 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Nicole K. Edlund | 11 Greenacres Avenue, West Hartford, CT 06107 | Master's Level Social Worker - Temporary Permit | ~ |
| Andrea M Yuliano | 39 Mountain Terrace Road, West Hartford, CT 06107 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Elizabeth M Ineson | 4 Linwold Dr, West Htfd, CT 06107 | Architect | 2020-08-01 ~ 2021-07-31 |
| Sarah G Potter | 19 Westland Ave, West Hartford, CT 06107 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Jessica C Abreu | 14 Deepwood Lane, West Hartford, CT 06107 | Real Estate Salesperson | 2020-06-18 ~ 2021-05-31 |
| William C Richter | 67 Hillsboro Drive, West Hartford, CT 06107 | Architect | 2020-08-01 ~ 2021-07-31 |
| Teresa M Stanton | 25 Common Dr., West Hartford, CT 06107 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06107 | |||
| City | WEST HARTFORD |
| Zip Code | 06107 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + WEST HARTFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Arnold W. Peterson Md | 999 Silver Ln Fl 3, Trumbull, CT 06611-5343 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Kent W Peterson | 901 Preston Ave, Ste.400, Charlottsville, VA 22903 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Carl G Peterson Jr | 155 Edgemere Way So, Naples, FL 34105 | Physician/surgeon | 1997-08-18 ~ 1998-10-31 |
| Richard C Peterson | 24a Heritage Crest, Southbury, CT 06488 | Physician/surgeon | 2008-08-18 ~ 2009-08-31 |
| Philip Raiford | 172 Peterson Rd, Pomfret Center, CT 06259 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Gregory N Peterson | 47 Walkley Road, West Hartford, CT 06119 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Judd Boloker Md | St Joe's Children's Hospital/div of Neonatology, Peterson, NJ 07503 | Physician/surgeon | 2004-02-19 ~ 2005-02-28 |
| Shannon Henning | 34 Cliff Road, Merrick, NY 11566 | Physician/surgeon | ~ |
| Shannon Drew Md | 291 Whitney Ave Ste 303, New Haven, CT 06511-3764 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shannon M Hogan Do | 185 Rye Cir, South Burlington, VT 05403-7648 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
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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).