SHAKAIB KHAN (Credential# 1180358) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
SHAKAIB KHAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0055953. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is Uconn School of Medicine, Farmington, CT 06030-0001. The current status is active.
| Licensee Name | SHAKAIB KHAN |
| Credential ID | 1180358 |
| Credential Number | CSP.0055953 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
Uconn School of Medicine Farmington CT 06030-0001 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2013-08-20 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1398575 | 1.056182 | Physician/Surgeon | 2017-02-24 | 2019-08-01 - 2020-07-31 | ACTIVE |
| 1487801 | 1.057464-RES | Resident Physician | 2017-06-28 | 2017-06-28 - 2018-06-27 | INACTIVE |
| Street Address | UCONN SCHOOL OF MEDICINE |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-0001 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kathryn A Becker | Uconn School of Medicine, Farmington, CT 06030-0001 | Resident Physician | 2018-07-01 ~ 2022-06-30 |
| Javeeria Manzoor | Uconn School of Medicine, Farmington, CT 06030-0001 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Grace Bundens | Uconn School of Medicine, Farmington, CT 06030-0001 | Resident Physician | 2017-07-01 ~ 2021-06-30 |
| Sarah M Benito Figueroa | Uconn School of Medicine, Farmington, CT 06030-0001 | Resident Physician | 2017-06-28 ~ 2021-06-30 |
| Caleb M Battersby | Uconn School of Medicine, Farmington, CT 06030-0001 | Resident Physician | 2017-06-28 ~ 2021-06-30 |
| Evan Boyle | Uconn School of Medicine, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Chay Bae | Uconn School of Medicine, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jennifer L Broess | Uconn School of Medicine, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Raminder Kaur Khangura | Uconn School of Medicine, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Nevena Radonjic | Uconn School of Medicine, Farmington, CT 06030-2103 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Wendy A Miller | Mc1921 Farmington Ave # 263, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jason J Ziegler | 2 Courthouse Square, Farmington, CT 06030-0001 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Bryden T Considine | L2104 of Medicine Rm, Farmington, CT 06030-0001 | Resident Physician | 2017-07-03 ~ 2021-06-30 |
| Dillon Paulo | 4260 Cordoba Ct, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Erica Shen Nofziger | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2027-06-30 |
| Omar Ibrahim | 263 Farmington Ave # Mc-1321, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jillian L Fortier | Uconn Health Center, Department of Surgery, Farmington, CT 06030-0001 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Douglas Zelisko | 263 Farmington Ave Dept Of, Farmington, CT 06030-0001 | Physician/surgeon | 2020-04-23 ~ 2021-01-31 |
| Ruchir D Trivedi | 263 Farmington Ave # Mc-1405, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Rawan J.j. Sarsour | 263 Farmington Ave # Mc3905, Farmington, CT 06030-0001 | Provisional Faculty Dentist | 2020-04-21 ~ 2021-04-30 |
| Find all Licenses in zip 06030-0001 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | FARMINGTON |
| Zip Code | 06030 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mukhtar I Khan Md | Po Box 122, Chelsea, NY 12512 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Gul Khan | 41 Brittany Ave, Trumbull, CT 06611-1104 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mohammed Khan | 24 Hospital Ave, Danbury, CT 06810-6099 | Controlled Substance Registration for Practitioner | 2009-09-02 ~ 2011-02-28 |
| Imad Khan | 56 Franklin St, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2011-04-18 ~ 2013-02-28 |
| Panyavee V Khan Md | 60 Rochford Ave, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2004-02-29 ~ 2005-02-28 |
| Sameer Khan | 3 Lake Pl Fl 2, New Haven, CT 06511-3615 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Adil H Khan | 168 York St Apt 2f, New Haven, CT 06511-4815 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Ayesha Khan | 67 Sand Pit Rd Ste 308, Danbury, CT 06810-4032 | Controlled Substance Registration for Practitioner | 2020-02-20 ~ 2021-02-28 |
| Izaz M Khan | 494 Worthington Rdg, Berlin, CT 06037-2341 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Abdus S Khan | 15 Fielding Ave, Dix Hills, NY 11746-7139 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
Please comment or provide details below to improve the information on SHAKAIB KHAN.
| 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).