SHAWN M ALLEN
Controlled Substance Registration for Practitioner


Address: 6753 Clyde St Fl 1, Forest Hills, NY 11375-4034

SHAWN M ALLEN (Credential# 509753) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.

Business Overview

SHAWN M ALLEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0044102. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2013. The expiration date is February 28, 2015. The business address is 6753 Clyde St Fl 1, Forest Hills, NY 11375-4034. The current status is inactive.

Basic Information

Licensee Name SHAWN M ALLEN
Credential ID 509753
Credential Number CSP.0044102
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 6753 Clyde St Fl 1
Forest Hills
NY 11375-4034
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2008-07-29
Effective Date 2013-03-01
Expiration Date 2015-02-28
Refresh Date 2016-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
925067 1.049018 Physician/Surgeon 2010-07-21 2013-08-01 - 2014-07-31 INACTIVE

Office Location

Street Address 6753 CLYDE ST FL 1
City FOREST HILLS
State NY
Zip Code 11375-4034

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Competitor

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City FOREST HILLS
Zip Code 11375
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FOREST HILLS

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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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