RANDALL D GRANT (Credential# 1050294) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
RANDALL D GRANT is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.050761-DO. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 30 Shelburne Rd, Stamford, CT 06902-3628. The current status is active.
| Licensee Name | RANDALL D GRANT |
| Credential ID | 1050294 |
| Credential Number | 1.050761-DO |
| Credential Type | Physician/Surgeon |
| Credential SubCategory | DO |
| Business Address |
30 Shelburne Rd Stamford CT 06902-3628 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2012-04-02 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-02-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1065563 | CSP.0052256 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2012-04-12 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 30 SHELBURNE RD |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902-3628 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nicole S Feagin | 30 Shelburne Rd, Stamford, CT 06902-3628 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Tracy Shevell Md | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hebroon Obaid | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Shelley Smith Tickett | 30 Shelburne Rd, Stamford, CT 06902-3628 | Physician/surgeon | 2018-04-01 ~ 2019-03-31 |
| Michelle R Maly | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2017-04-21 ~ 2019-02-28 |
| Diana M Bernal-messinger Aprn | 30 Shelburne Rd, Stamford, CT 06902 | Controlled Substance Registration for Practitioner | 2017-04-20 ~ 2019-02-28 |
| Molly Findley | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Maureen C Burke | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Jennifer Cabral | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2015-03-23 ~ 2017-02-28 |
| Elizabeth M Rodriguez | 30 Shelburne Rd, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marcos Valerio | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-06 ~ 2021-02-28 |
| Antonia L Green | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| John F Ciannella Md | One Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sasha Cobotic | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Dmitry Meyerovich | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Arunabha Nandi | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Julianne M Wilmot | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kamal Addagatla | Department of Surgery, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Chao Guo | 59 Liberty Street, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Basil N Waoz | 1 Hospital Plaza, Stamford, CT 06902-3628 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Find all Licenses in zip 06902-3628 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeris Maydeli Flores | 153 Fairfield Av, Stamford, CT 06902 | Nail Technician | ~ |
| Reynaldo De La Cruz | 64 Brookside Drive, Stamford, CT 06902 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Darren J Petillo | 5 Hundley Court, Stamford, CT 06902 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Antonios Restaurant | 405 West Main St, Stamford, CT 06902 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Edward Smith | 184 Fairfield Ave., Stamford, CT 06902 | Home Improvement Contractor | ~ |
| Margaret A Dorrance | 24c Hamilton Court, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carolyn Maguire | 48 Nelson St, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Evelyne Joassin | 17 George St., Stamford, CT 06902 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Andrea Bynoe | 34 Melrose Pl, Stamford, CT 06902 | Notary Public Appointment | 1994-04-06 ~ 1999-04-30 |
| Ravi K Ahuja | 296 Westover Rd, Stamford, CT 06902 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06902 | |||
| City | STAMFORD |
| Zip Code | 06902 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + STAMFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Randall B Kaump | 50 Hunters Way, Hamden, CT 06514 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Randall H. Safarik | 921 Oak Park Blvd. #203, Pismo Beach, CA 93449 | Physician/surgeon | ~ |
| Randall C Lewis | 40 Springwood Dr, Monroe Township, NJ 08831-3270 | Physician/surgeon | 2012-01-23 ~ 2012-04-30 |
| Randall Keith Pearson | 200 First Street Sw, Rochester, MN 55905 | Physician/surgeon | 2019-04-01 ~ 2020-03-31 |
| Keith Randall Young Jr | 789 Howard Avenue, New Haven, CT 06504 | Physician/surgeon | 1980-05-05 ~ 1983-04-30 |
| Jeffrey Randall Murray | 28 Harbor Heights Rd, Scituate, MA 02066-1320 | Physician/surgeon | 1987-03-13 ~ 1988-05-31 |
| Donna D Randall | 1074 Lombard Avenue, St. Paul, MN 55105 | Physician/surgeon | 2004-04-19 ~ 2005-04-30 |
| Randall R Dwenger Md | 30 Cedar Crest Road, Salisbury, CT 06068 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Matthew Randall Faiman | 5001 Rockside Rd In30, Independence, OH 44131 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Randall J. Risinger | 1111 Cromwell Ave, Bldg 4, Rocky Hill, CT 06067 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
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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).