BENJAMIN S BUNNEY MD (Credential# 540993) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is October 1, 2015. The license expiration date date is September 30, 2016. The license status is INACTIVE.
BENJAMIN S BUNNEY MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.014149. The credential type is physician/surgeon. The effective date is October 1, 2015. The expiration date is September 30, 2016. The business address is 1636 Newbury Neck Rd, Surry, ME 04684-3827. The current status is inactive.
| Licensee Name | BENJAMIN S BUNNEY MD |
| Credential ID | 540993 |
| Credential Number | 1.014149 |
| Credential Type | Physician/Surgeon |
| Business Address |
1636 Newbury Neck Rd Surry ME 04684-3827 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1969-12-03 |
| Effective Date | 2015-10-01 |
| Expiration Date | 2016-09-30 |
| Refresh Date | 2017-01-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 162967 | CSP.0022863 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-03-01 - 2015-02-28 | INACTIVE | |
| 1035931 | CSP.0051501 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | - | INACTIVE |
| Street Address | 1636 NEWBURY NECK RD |
| City | SURRY |
| State | ME |
| Zip Code | 04684-3827 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sherrie Fowler | Rr1 Box 1836, Surry, ME 04684 | Hairdresser/cosmetician | 2000-08-17 ~ 2001-08-31 |
| Moira K O'neill | 1035 Newbury Neck Rd, Surry, ME 04684-3800 | Registered Nurse | 2016-06-01 ~ 2017-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Dawn R Dejnak · Trickett, Tucker | 603 Route 12 A, Surry, NH 03431 | Registered Nurse | 2014-09-01 ~ 2015-08-31 |
| Eileen M Duffy | 50 Village Road, Surry, NH 03431 | Registered Nurse | 2014-07-01 ~ 2015-06-30 |
| Lavonne S Allen | 47 Hayward Dr, Surry, NH 03431 | Registered Nurse | 1995-04-03 ~ 1996-03-31 |
| Ramona L Hoyt | Po Box 172, Surry, VA 23883-0172 | Registered Nurse - Temporary | 2011-02-16 ~ 2011-06-16 |
| City | SURRY |
| Zip Code | 04684 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + SURRY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrew S Bunney | 1150 Hennepin Ave Apt H901, Minneapolis, MN 55403-1756 | Resident Physician | 2015-06-25 ~ 2019-06-30 |
| Benjamin Stein | 161 Madison Ave, New York, NY 10016 | Physician/surgeon | ~ |
| Benjamin Richard Jacobs | CT | Physician/surgeon | ~ 1992-03-31 |
| Benjamin Kahn | 40 Abrams Rd, Cheshire, CT 06410 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Benjamin J Freda Do | 100 Wason Ave Ste 200, Springfield, MA 01107-1119 | Physician/surgeon | 2014-09-01 ~ 2015-08-31 |
| Benjamin A Hagendorf | 80 Seymour Street, Hartford, CT 06102 | Physician/surgeon | ~ |
| Benjamin F Gruenbaum | 546 Riverside Dr, Fairfield, CT 06824 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Benjamin J Wycherly Md | 21 South Rd Ste 112, Farmington, CT 06032-2482 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Benjamin J Gilson | 18 Chestnut St, Newport, RI 02840 | Physician/surgeon | 1993-09-23 ~ 1994-08-31 |
| Benjamin D Gordon Md | 14 Hillsea Rd, Yarmouth, MD 02675-1111 | Physician/surgeon | 2003-01-16 ~ 2004-03-31 |
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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).