SHANNON LOUISE DONOVAN MAZUR (Credential# 2033676) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license status is PENDING.
SHANNON LOUISE DONOVAN MAZUR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0073494. The credential type is controlled substance registration for practitioner. The business address is 66 Amherst Rd, South Hadley, MA 01075-1202. The current status is pending.
| Licensee Name | SHANNON LOUISE DONOVAN MAZUR |
| Credential ID | 2033676 |
| Credential Number | CSP.0073494 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
66 Amherst Rd South Hadley MA 01075-1202 |
| Business Type | INDIVIDUAL |
| Status | PENDING - WAITING FOR ACTIVE LICENSE FROM DPH |
| Refresh Date | 2020-04-09 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 2020037 | 1 | Physician/Surgeon | - | PENDING |
| Street Address | 66 AMHERST RD |
| City | SOUTH HADLEY |
| State | MA |
| Zip Code | 01075-1202 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jason T Shattuck | 45 Hadley Village Rd, South Hadley, MA 01075 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Julie-ellen Frost | 20 Willimansett St, South Hadley, MA 01075 | Registered Nurse | ~ |
| Jeffrey D Squire | 25 Parkview Dr, South Hadley, MA 01075 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Erin Claire Zwisler | 46 Saint Kolbe Dr., Holyoke, MA 01075 | Behavior Analyst | ~ |
| Tanya L Lieser | 14 Mountainview Street, South Hadley, MA 01075 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Pamela M Proulx | 22 Wilson Street, South Hadley, MA 01075 | Physical Therapist | 2020-04-01 ~ 2021-03-31 |
| Rebecca F Quenneville | 121 The Meadows, South Hadley, MA 01075 | Registered Nurse | ~ 2018-02-28 |
| Raymond L Brousseau | 43 West Summit Street 10, South Hadley, MA 01075 | Notary Public Appointment | 2014-12-03 ~ 2019-12-31 |
| Carla D Gaouette | 103 Bardwell Street, South Hadley, MA 01075 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| James E Dougherty | 23 Bunker Hill Street, South Hadley, MA 01075 | Pharmacy Technician | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 01075 | |||
| City | SOUTH HADLEY |
| Zip Code | 01075 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SOUTH HADLEY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric M Mazur Md | 53 Vermillion Drive, Avon, CT 06001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Ryan J Donovan Pa | 40 Brookside Pl, Cheshire, CT 06410 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Elaine Donovan | 188 Atkins St, Meriden, CT 06450 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kenneth W Donovan Md | 26 Dawley Dr, Stonington, CT 06378-2021 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lisa O'donovan | 20 York St Rm 226, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-06-05 ~ 2021-02-28 |
| James F Donovan Md | 211 Farmcliff Dr, Glastonbury, CT 06033 | Controlled Substance Registration for Practitioner | 1993-05-14 ~ 1995-06-01 |
| Lisa M Donovan Md | 27 Red Cross Ave, Newport, RI 02840 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Derek William Donovan | 484 Middletown Rd, Colchester, CT 06415-2230 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Rachel Donovan Lnm | 531 Neipsic Road, Glastonbury, CT 06033 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Cristina Donovan | 225 Brush Hill Rd, Litchfield, CT 06759-3218 | Controlled Substance Registration for Practitioner | ~ |
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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).