EDMUND WEST (Credential# 541558) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
EDMUND WEST is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.015603. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is Pawcatuck Family Practice, Pawcatuk, CT 06379. The current status is active.
| Licensee Name | EDMUND WEST |
| Credential ID | 541558 |
| Credential Number | 1.015603 |
| Credential Type | Physician/Surgeon |
| Business Address |
Pawcatuck Family Practice Pawcatuk CT 06379 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - PRIOR DISCIPLINE |
| Active | 1 |
| Issue Date | 1972-09-18 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-03-09 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 300336 | CSP.0002528 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | Pawcatuck Family Practice |
| City | Pawcatuk |
| State | CT |
| Zip Code | 06379 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Vinessa Job | 45 Aimee Dr, Pawcatuck, CT 06379 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Rosanne M Giuliano | 25 Davis Avenue, Pawcatuck, CT 06379 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Mary Kathleen Lettich | 15 Canterbury Lane, Stonington, CT 06379 | Behavior Analyst | ~ |
| Deanna L. Boileau-gilman | 37 William Street, Pawcatuck, CT 06379 | Massage Therapist | 2020-08-01 ~ 2022-07-31 |
| Stuart A Lamb | 40 Lester Ave., Pawcatuck, CT 06379 | Optician | 2020-09-01 ~ 2021-08-31 |
| Lisa S Dittman · Boyd | 302 N Anguilla Rd, Pawcatuck, CT 06379 | Physical Therapist | 2020-07-01 ~ 2021-06-30 |
| Naomi Gobeille | 2 North Broad Street, Pawcatuck, CT 06379 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Sherrie L Theroux | 7 Pond View Ct, Pawcatuck, CT 06379 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Robin R Dana | 17 Wilcox Manor, Pawcatuck, CT 06379 | Professional Counselor | 2020-09-01 ~ 2021-08-31 |
| Sharon Marquis | 20 West Enterprise, Pawcatuck, CT 06379 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Find all Licenses in zip 06379 | |||
| City | Pawcatuk |
| Zip Code | 06379 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Pawcatuk |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Edmund F Ziegler | 87 Lincoln St, New Britain, CT 06052 | Physician/surgeon | 1993-11-10 ~ 1994-10-31 |
| Edmund A Kim Md | Prohealth Physicians, Farmington, CT 06032 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Edmund H Olson Md | 100 Retreat Ave, Hartford, CT 06106 | Physician/surgeon | 2008-06-25 ~ 2009-07-31 |
| Edmund A Ganal | 131 Kent Rd, New Milford, CT 06776-3485 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Edmund F Hecklau | 36 River Ridge Ct, Stamford, CT 06902 | Physician/surgeon | 2007-05-07 ~ 2008-05-31 |
| Edmund Y Chung | 410 Saybrook Rd Suite 201, Middletown, CT 06457 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Edmund J Brennan | 299 Forest Ridge Rd, Waterbury, CT 06708 | Physician/surgeon | 2003-03-12 ~ 2004-03-31 |
| Edmund Quinn | 78 Reservoir Ridge Dr, Southington, CT 06489-1356 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Edmund D Marinucci | 13 Oyster Reef Rd, Savannah, GA 31411 | Physician/surgeon | 2007-07-16 ~ 2008-06-30 |
| Edmund Dennis Harris | 22 Llanfair Rd, Unit 6, Ardmore, PA 19003-2320 | Physician/surgeon | 2019-09-20 ~ 2020-08-31 |
Please comment or provide details below to improve the information on EDMUND WEST.
| 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).