JOHN A MCDOUGALL
Resident Physician


Address: Po Box 3669, Shiprock, NM 87420

JOHN A MCDOUGALL (Credential# 1490841) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is June 27, 2014. The license expiration date date is June 30, 2021. The license status is ACTIVE.

Business Overview

JOHN A MCDOUGALL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.058943-RES. The credential type is resident physician. The effective date is June 27, 2014. The expiration date is June 30, 2021. The business address is Po Box 3669, Shiprock, NM 87420. The current status is active.

Basic Information

Licensee Name JOHN A MCDOUGALL
Credential ID 1490841
Credential Number 1.058943-RES
Credential Type Resident Physician
Credential SubCategory RES
Business Address Po Box 3669
Shiprock
NM 87420
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2014-06-27
Effective Date 2014-06-27
Expiration Date 2021-06-30
Refresh Date 2020-05-27

Other licenses

ID Credential Code Credential Type Issue Term Status
1343179 1.055177 Physician/Surgeon 2016-04-18 2020-01-01 - 2020-12-31 ACTIVE
1303800 CSP.0061235 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2015-08-07 2017-12-11 - 2019-02-28 LAPSED
1236345 CSP.0058302 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2014-07-31 2014-07-31 - 2015-02-28 INACTIVE

Office Location

Street Address PO Box 3669
City SHIPROCK
State NM
Zip Code 87420

Competitor

Search similar business entities

City SHIPROCK
Zip Code 87420
License Type Resident Physician
License Type + County Resident Physician + SHIPROCK

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Dataset Information

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).

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