SHAWN B BACKUS (Credential# 1402426) is licensed (Registered Nurse) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2017. The license expiration date date is June 30, 2018. The license status is INACTIVE.
SHAWN B BACKUS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #10.142420. The credential type is registered nurse. The effective date is June 1, 2017. The expiration date is June 30, 2018. The business address is 2221 S Webster Ave Ste A160, Green Bay, WI 54301-2158. The current status is inactive.
| Licensee Name | SHAWN B BACKUS |
| Credential ID | 1402426 |
| Credential Number | 10.142420 |
| Credential Type | Registered Nurse |
| Business Address |
2221 S Webster Ave Ste A160 Green Bay WI 54301-2158 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2017-06-01 |
| Effective Date | 2017-06-01 |
| Expiration Date | 2018-06-30 |
| Refresh Date | 2018-10-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1403124 | 10.140463-TEMP | Registered Nurse - Temporary | 2017-02-15 | 2017-02-15 - 2017-06-14 | INACTIVE |
| Street Address | 2221 S WEBSTER AVE STE A160 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-2158 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Donna J Boehm | 809 S. Adams Street, Greenbay, WI 54301 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Cynthia L Jones | 532 Arrowhead Dr., Greenbay, WI 54301 | Licensed Clinical Social Worker | 2008-06-26 ~ 2009-07-31 |
| Kimberly L Cichocki | 1264 Cherry St, Green Bay, WI 54301 | Registered Nurse | 1999-10-22 ~ 2000-09-30 |
| Jared R Vanden Branden | 2513 S. Webster, Green Bay, WI 54301 | Respiratory Care Practitioner | 2004-08-02 ~ 2005-03-31 |
| Dana M Pisculich | 1263 Emilie Street, Green Bay, WI 54301 | Occupational Therapist | 2004-08-20 ~ 2005-07-31 |
| Elizabeth A Hoppen | 3901 East River Dr, Green Bay, WI 54301 | Emergency Medical Technician | ~ 1997-04-01 |
| George R Hoppen | 3646 Ulmcrest Crt, Green Bay, WI 54301 | Professional Engineer | 1997-02-01 ~ 1998-01-31 |
| Derek T O'dell | 535 Gwynn St, Green Bay, WI 54301-1058 | Public Service Technician - Telephone | 2008-10-03 ~ 2009-09-30 |
| Mei Fredeen | 523 Chardonnay Ct, Green Bay, WI 54301-1401 | Emergency Medical Technician | 2019-08-06 ~ 2022-06-30 |
| David E Laurent | 234 Coolidge St, Green Bay, WI 54301-1616 | Public Service Technician - Telephone | 2008-10-03 ~ 2009-09-30 |
| Find all Licenses in zip 54301 | |||
| City | GREEN BAY |
| Zip Code | 54301 |
| License Type | Registered Nurse |
| License Type + County | Registered Nurse + GREEN BAY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Backus Health Center | 80 Norwich New London Tpke, Uncasville, CT 06382-2527 | Outpatient Clinic | 2014-07-01 ~ 2018-06-30 |
| Laurie Backus | 7 Pleasant St, Cos Cob, CT 06807 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Amelia D Backus | 7 Woodview Dr, Brookfield, CT 06804 | Registered Nurse | 2017-11-01 ~ 2018-10-31 |
| Laura Backus | 90 Griffin Ave, Bridgeport, CT 06606-2426 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Mavourneen A Backus | 49 Bradfield Dr, Somers, CT 06071 | Registered Nurse | 2011-08-01 ~ 2012-07-31 |
| Mary K Backus | 90 Griffin Ave, Bridgeport, CT 06606-2426 | Registered Nurse | 2018-02-01 ~ 2019-01-31 |
| Helen M Backus | 45 Edgerton St, Darien, CT 06820 | Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Backus Health Center | 12 Case St Ste 305, Norwich, CT 06360-2294 | Outpatient Clinic | 2013-02-04 ~ 2016-12-31 |
| Lucy A Davidson | W.w. Backus Hospital, Norwich, CT 06360 | Registered Nurse | 2018-06-01 ~ 2019-05-31 |
| Michele A Backus | 53 Mansion Road, Wallingford, CT 06492 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
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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).