JONATHAN TERRY MARSHALL (Credential# 1376264) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is October 1, 2018. The license expiration date date is September 30, 2019. The license status is INACTIVE.
JONATHAN TERRY MARSHALL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.055990. The credential type is physician/surgeon. The effective date is October 1, 2018. The expiration date is September 30, 2019. The business address is 199 Park Club Lane Suite 300, Williamsville, NY 14221. The current status is inactive.
| Licensee Name | JONATHAN TERRY MARSHALL |
| Credential ID | 1376264 |
| Credential Number | 1.055990 |
| Credential Type | Physician/Surgeon |
| Business Address |
199 Park Club Lane Suite 300 Williamsville NY 14221 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2016-12-05 |
| Effective Date | 2018-10-01 |
| Expiration Date | 2019-09-30 |
| Refresh Date | 2020-01-03 |
| Street Address | 199 Park Club Lane Suite 300 |
| City | Williamsville |
| State | NY |
| Zip Code | 14221 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Keyur Suryakant Shah | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2018-11-01 ~ 2019-10-31 |
| Michael Frank Tabone | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2018-02-01 ~ 2019-01-31 |
| Douglas Stephen Drumsta | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2018-02-01 ~ 2019-01-31 |
| Charles James Lesh | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2018-02-01 ~ 2019-01-31 |
| Jason Robert Pericak | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2018-01-01 ~ 2018-12-31 |
| Anthony Robert Mangano | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2017-12-01 ~ 2018-11-30 |
| Phillip Adam Baum | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2017-11-01 ~ 2018-10-31 |
| Andrew Terrell Dunn | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2017-08-01 ~ 2018-07-31 |
| Thomas Anthony Lostracco | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2017-08-01 ~ 2018-07-31 |
| Kenneth Daniel Pearsen | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2017-08-01 ~ 2018-07-31 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marc C Mussachio | 30 N Forest Rd, Williamsville, NY 14221 | Architect | 2020-08-01 ~ 2021-07-31 |
| Kathleen A Swann | 2330 Maple Rd, Williamsville, NY 14221 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Asher B Blum | 163 Viscount Dr, Williamsville, NY 14221 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| David R Ludwig | 75 Farmington Road, Williamsville, NY 14221 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Andrew V Terragnoli | 205 Maple Rd, Williamsville, NY 14221 | Professional Engineer | 2020-02-24 ~ 2021-01-31 |
| Adrian A Forzani II | 158 Brushcreek Rd, Williamsville, NY 14221 | Professional Engineer | 2014-02-01 ~ 2015-01-31 |
| Yasser M Heakal | 70 Glendon Pl, Williamsville, NY 14221 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Neiman Funds | 6631 Main Street, Williamsville, NY 14221 | Investment Company - Open End | 2019-12-31 ~ 2020-12-31 |
| Shelina Siu | 84 Sandhurst Ct, Williamsville, NY 14221 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Satish B Mohan · Progressive Builders | 126 Viscount Dr, Williamsville, NY 14221 | Home Improvement Contractor | 2018-09-20 ~ 2019-11-30 |
| Find all Licenses in zip 14221 | |||
| City | Williamsville |
| Zip Code | 14221 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Williamsville |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Terry F Reardon | 512 Saybrook Rd, Middletown, CT 06457 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Bryan Albert Terry | C/o 20 York St, New Haven, CT 06510 | Physician/surgeon | ~ |
| Lewis N Terry Jr | 200 Patewood Dr, Greenville, SC 29615-3593 | Physician/surgeon | 1965-08-13 ~ |
| Terry L Levin | 714 Forest Ave, Mamaroneck, NY 10543-4415 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Marshall E. Bein | 910 Wellesley Ave, Los Angeles, CA 90049-5823 | Physician/surgeon | 1975-06-13 ~ 2019-01-29 |
| Terry D Ryan Md | 11 West Lane, Niantic, CT 06357 | Physician/surgeon | 2015-12-01 ~ 2016-11-30 |
| Terry K Schultz | 1552 Whitney Ave, Hamden, CT 06517 | Physician/surgeon | 1972-07-27 ~ 1973-11-30 |
| Kimberly D Terry | 7 Park Mountain, San Antonio, TX 78255 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
| Marshall Wold Md | 355 Thayer St, Providence, RI 02906 | Physician/surgeon | 2006-01-30 ~ 2007-03-31 |
| Chetan Vaid | 11 Marshall St, Old Greenwich, CT 06870-1218 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
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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).