SHANTELLE D BROKAW (Credential# 998739) is licensed (Registered Nurse) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
SHANTELLE D BROKAW is licensed with the Department of Consumer Protection of Connecticut. The credential number is #10.100620. The credential type is registered nurse. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 11 Lakeshore Drive, Farmington, CT 06032. The current status is active.
| Licensee Name | SHANTELLE D BROKAW |
| Credential ID | 998739 |
| Credential Number | 10.100620 |
| Credential Type | Registered Nurse |
| Business Address |
11 Lakeshore Drive Farmington CT 06032 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2011-07-05 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-05-18 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1388247 | 12.006831 | Advanced Practice Registered Nurse | 2016-11-14 | 2020-06-01 - 2021-05-31 | ACTIVE |
| 1389837 | CSP.0064365 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-11-18 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 11 Lakeshore Drive |
| City | Farmington |
| State | CT |
| Zip Code | 06032 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kyeongsuk Lee Lee | 11- A1 Lakeshore Dr, Farmington, CT 06032 | Nail Technician | ~ |
| Lynne M Ramer · Sobowicz | 13 Wentworth Park, Farmington, CT 06032 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Scott's Townline Mobil LLC | 435 Main St, Farmington, CT 06032 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Glenna E Voytovich · Mietz | 47 Carriage Dr, Farmington, CT 06032 | Marital and Family Therapist | 2020-09-01 ~ 2021-08-31 |
| Munsons Chocolates | 463 Westfarms Mall, Farmington, CT 06032 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Kimberly A. Caprio | Hartford Healthcare Medical Group, Farmington, CT 06032 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Stephanie A. Fink | 22 Kent Lane, Farmington, CT 06032 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Farmington Donuts LLC · Dunkins Donuts | 348 Colt Hwy, Farmington, CT 06032 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Angham Zakko | 2 Stratford Rd., Farmington, CT 06032 | Architect | 2020-08-01 ~ 2021-07-31 |
| Thomas N Taylor | 222 Main St # 264, Farmington, CT 06032 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06032 | |||
| City | Farmington |
| Zip Code | 06032 |
| License Type | Registered Nurse |
| License Type + County | Registered Nurse + Farmington |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brokaw Design Inc | 6060 Dawn Dr, Rohnert Park, CA 94928-2205 | Professional Engineering Corporation | 2020-07-19 ~ 2021-07-18 |
| Shantelle Rosado | 21 Ashley St, Springfield, MA 01105-1515 | Registered Nurse | 2013-02-01 ~ 2014-01-31 |
| Shantelle Rae Feragen | 5452 Sanibel Dr, Minnetonka, MN 55343-9474 | Registered Nurse | 2020-06-08 ~ 2021-05-31 |
| Margaret Brokaw | 405 High Ridge Dr, Bridgeport, CT 06606 | Registered Nurse | 1994-08-08 ~ 1995-10-31 |
| Leslie B Brokaw | Walnut Tree Hill, Sandy Hook, CT 06482 | Registered Nurse | 2005-02-28 ~ 2006-04-30 |
| Shantelle L Mojica | 4 Donny Dr, Wappingers Falls, NY 12590-2313 | Radiographer | 2014-03-13 ~ 2015-01-31 |
| Shantelle Gonzales | 417 Storrs Road, Mansfield Center, CT 06250 | Medication Administration Certification | ~ |
| Shantelle Petrone | 71 Bemis Street, Terryville, CT 06786 | Notary Public Appointment | 2016-08-12 ~ 2021-08-31 |
| Shantelle Weir | 120 Holcomb Street, Hartford, CT 06112-1589 | Medication Administration Certification | 2017-10-19 ~ 2019-10-18 |
| Carl Brokaw | 21 Varno Ln, Enfield, CT 06082-2636 | Radiographer | 2014-06-01 ~ 2015-05-31 |
Please comment or provide details below to improve the information on SHANTELLE D BROKAW.
| 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).