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.
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.
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 |
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 |
Street Address | PO Box 3669 |
City | SHIPROCK |
State | NM |
Zip Code | 87420 |
City | SHIPROCK |
Zip Code | 87420 |
License Type | Resident Physician |
License Type + County | Resident Physician + SHIPROCK |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Leslie Mcdougall | 176 Brothers Court, Port Matilda, PA 16870 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
Blessy John | 95 Luciani Rd, Woodbridge, CT 06525-2316 | Resident Physician | 2015-06-24 ~ 2020-06-30 |
John T Creegan | 267 Lincoln Pl Apt 4a, Brooklyn, NY 11238-5704 | Resident Physician | 2017-06-28 ~ 2021-06-30 |
John L Collar | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-06-09 ~ 2021-06-30 |
John M Astle | 20 York St Tmp 209, New Haven, CT 06510-3220 | Resident Physician | 2015-06-29 ~ 2019-06-30 |
John B Fournier | 20 York St, New Haven, CT 06510 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
Seongho John Jeong | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-06-09 ~ 2021-06-30 |
Edward John Detweiler | 476 Roy St, West Hempstead, NY 11552-2228 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
John Anthonypillai | 6 Devine St Fl 2, North Haven, CT 06473-2195 | Resident Physician | 2018-08-14 ~ 2021-06-30 |
Austin John Mchenry | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
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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).