AMANDA L HOLLOWAY (Credential# 1427050) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is May 9, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
AMANDA L HOLLOWAY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0065602. The credential type is controlled substance registration for practitioner. The effective date is May 9, 2019. The expiration date is February 28, 2021. The business address is 8206 W Wilderness Way, Shreveport, LA 71106. The current status is active.
| Licensee Name | AMANDA L HOLLOWAY |
| Credential ID | 1427050 |
| Credential Number | CSP.0065602 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
8206 W Wilderness Way Shreveport LA 71106 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-05-30 |
| Effective Date | 2019-05-09 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-05-09 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1489395 | 1.058601-RES | Resident Physician | 2017-07-01 | 2017-07-01 - 2020-06-30 | ACTIVE |
| Street Address | 8206 W WILDERNESS WAY |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sanjay R Jain | 302 Peach Drive, Shreveport, LA 71106 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Robert Newton Schwendimann | 751 Oneota St., Shreveport, LA 71106 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
| Dr. Reddy's Laboratories LLC · Dr. Reddy's Laboratories Louisiana, LLC | 880 Line Avenue, Shreveport, LA 71106 | Out of State Manufacturer of Drugs, Cosmetics & Medical Devices | 2013-07-24 ~ |
| Rosemary Smithyman | 11230 Magnolia Glen, Shreveport, LA 71106 | Speech and Language Pathologist | 2014-09-01 ~ 2015-08-31 |
| Basf Corporation | 8800 Line Avenue, Shreveport, LA 71106 | Manufacturer of Drugs, Cosmetics & Medical Devices | ~ |
| John J Ward | 6030 Line Ave Ste 210, Shreveport, LA 71106-2073 | Physician/surgeon | 2010-10-01 ~ 2011-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Morris & Dickson Co LLC | 10301 Hwy 1 South, Shreveport, LA 71115 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Kristina K Prestridge | 1925 E 70th St #52482, Shreveport, LA 71105-0002 | Registered Nurse | 2020-05-01 ~ 2020-12-31 |
| Phyllis T Lambert | 111 Palladium Lane, Shreveport, LA 71115 | Professional Counselor | 2020-05-01 ~ 2021-04-30 |
| Matthew Lamar Mcinnis | 6104 Ambleside St, Shreveport, LA 71129-3410 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Sarah Hope Laramie | 333 Texas Street #1900, Shreveport, LA 71101 | Certified Public Accountant License | 2019-01-01 ~ 2019-12-31 |
| Sealy Industrial Partners, Lp | 333 Texas Street, Shreveport, LA 71101 | Securities - Exemptions | 2019-12-26 ~ |
| Stancy T Coleman | 8055 Captain Mary Miller Dr, Shreveport, LA 71115-2948 | Registered Nurse | 2020-03-01 ~ 2021-02-28 |
| Secor Upson | 8700 Millicent Way Apt 711, Shreveport, LA 71115-2254 | Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Veronica Choyce | 3802 Oakcrest Lane, Shreveport, LA 71109 | Registered Nurse | 2018-09-01 ~ 2019-08-31 |
| Kayla Brianne Kinnebrew | 317 Haynes Ave, Shreveport, LA 71105 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Find all Licenses in SHREVEPORT | |||
| City | SHREVEPORT |
| Zip Code | 71106 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SHREVEPORT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Destini Holloway | 5 Country Squire Dr Unit C, Cromwell, CT 06416-2518 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Amanda N Rea | 195 Broadmere Rd, Stratford, CT 06614 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda Lu | 71 Haynes St, Manchester, CT 06040-4131 | Controlled Substance Registration for Practitioner | 2019-05-29 ~ 2021-02-28 |
| Amanda H Uva | 6 Chiltern St, Farmington, CT 06032-1533 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda N Kallen Md | Po Box 268, Middle Haddam, CT 06456 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda Shreders | 772 Westover Rd, Stamford, CT 06902-1329 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Amanda Fazzalari | 56 Franklin St, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda L Wilmot | 24 Hospital Ave, Danbury, CT 06810-6099 | Controlled Substance Registration for Practitioner | 2015-03-20 ~ 2017-02-28 |
| Amanda R Cook | 28 Augusta Dr, Milford, CT 06461-1683 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda Mallico Pa | 15 Maple Ln, Avon, CT 06001 | Controlled Substance Registration for Practitioner | 2003-03-01 ~ 2004-02-28 |
Please comment or provide details below to improve the information on AMANDA L HOLLOWAY.
| 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).