SHANNON MCKERNAN SUTHERLAND (Credential# 1237460) 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.
SHANNON MCKERNAN SUTHERLAND is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0058366. 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 330 Western Blvd Ste 102, Glastonbury, CT 06033-4383. The current status is active.
Licensee Name | SHANNON MCKERNAN SUTHERLAND |
Credential ID | 1237460 |
Credential Number | CSP.0058366 |
Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
Business Address |
330 Western Blvd Ste 102 Glastonbury CT 06033-4383 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2014-07-31 |
Effective Date | 2019-03-01 |
Expiration Date | 2021-02-28 |
Refresh Date | 2019-01-03 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1500753 | 1.061130 | Physician/Surgeon | 2018-05-30 | 2019-08-01 - 2020-07-31 | ACTIVE |
1488870 | 1.058265-RES | Resident Physician | 2014-07-01 | 2014-07-01 - 2018-06-30 | INACTIVE |
843927 | 70.004194 | Emergency Medical Technician | 2003-10-08 | 2005-07-19 - 2007-06-30 | INACTIVE |
Street Address | 330 WESTERN BLVD STE 102 |
City | GLASTONBURY |
State | CT |
Zip Code | 06033-4383 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Odin K Kuiper Md | 330 Western Blvd Ste 102, Glastonbury, CT 06033-4383 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
Jennifer S Wethje Aprn | 330 Western Blvd Ste 102, Glastonbury, CT 06033-4383 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Patricia L Fagan | 330 Western Blvd Ste 102, Glastonbury, CT 06033-4383 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
Matthew L Saidel | 330 Western Blvd Ste 102, Glastonbury, CT 06033-4383 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Jodi M Leopold | 330 Western Blvd Ste 102, Glastonbury, CT 06033-4383 | Physician/surgeon | 2016-12-01 ~ 2017-11-30 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Brigitte P Worgaftik Md | 330 Western Blvd, Glastonbury, CT 06033-4383 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Mary E Farwell | 330 Western Blvd, Glastonbury, CT 06033-4383 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Vanessa Segal | 46 Salem Court, Glastonbury, CT 06033 | Hairdresser/cosmetician | ~ |
Laura Nadeau | 3641 Hebron Ave, Glastonbury, CT 06033 | Respiratory Care Practitioner | 2020-08-01 ~ 2021-07-31 |
Abigail Lynn Hubbard | 55 Brookview Drive, Glastonbury, CT 06033 | Emergency Medical Technician | ~ |
Maureen E Booth | 36 Hubbard Run Drive, Glastonbury, CT 06033 | Speech and Language Pathologist | 2020-07-01 ~ 2021-06-30 |
Wendy B Johnson | 1789 Main St, Glastonbury, CT 06033 | Architect | 2020-08-01 ~ 2021-07-31 |
Michael D Devanney Pa | 28 Evergreen Ln, Glastonbury, CT 06033 | Physician Assistant | 2020-09-01 ~ 2021-08-31 |
Sophie C Gomez · Pirog | 81 Three Mile Rd, Glastonbury, CT 06033 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
Jennifer R Briones | 90 Deerfield Drive, Glastonbury, CT 06033 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Munson's Chocolates | 135 Glastonbury Blvd, Glastonbury, CT 06033 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Yulhun Sung | 245 Griswold St Unit A, Glastonbury, CT 06033 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
Find all Licenses in zip 06033 |
City | GLASTONBURY |
Zip Code | 06033 |
License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + GLASTONBURY |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Stuart D Sutherland | 41 Pequot Dr, Rocky Hill, CT 06067-3151 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
Lynn A Beinfield Md | 1510 Sutherland Creek Rd, Manitou Springs, CO 80829 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
Shannon S Maher | 16 Cat Rock Rd, Cos Cob, CT 06807-1704 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
Shannon R Packer | 68 Chatham Dr, Manchester, CT 06042-8521 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Shannon L Degroff | 11 Acre Way, Southington, CT 06489-2253 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Shannon M Marcotte Do | 71 Haynes St, Manchester, CT 06040 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
Shannon M Bertolino Dvm | 31 Gracey Rd, Canton, CT 06019-2471 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Shannon M Lynch | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Shannon P Marsh | 114 Woodland St, Hartford, CT 06105-1208 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Shannon P Martinello Md | 1 Bradley Rd Ste 102, Woodbridge, CT 06525-2235 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on SHANNON MCKERNAN SUTHERLAND.
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).