SCOTT J SULLIVAN (Credential# 556589) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
SCOTT J SULLIVAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.039001. The credential type is physician/surgeon. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 11995 Singletree Lane, Eden Prairie, MN 55344. The current status is active.
| Licensee Name | SCOTT J SULLIVAN |
| Credential ID | 556589 |
| Credential Number | 1.039001 |
| Credential Type | Physician/Surgeon |
| Business Address |
11995 Singletree Lane Eden Prairie MN 55344 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2000-09-14 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-01-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 264802 | CSP.0030592 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2001-03-19 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 11995 Singletree Lane |
| City | Eden Prairie |
| State | MN |
| Zip Code | 55344 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Donald T Nicell | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Alan J Kopp | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Jennifer Kim Md | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Joseph Michael Rozell | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Jeffrey Brian Cutler | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Wendy Elaine Zimmer | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Richard T. Kaplan | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Kevin Charles Wright | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Raymond Bozman | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Christopher M. Garcia | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Neuroone Medical Technologies Corp | 7599 Anagram Dr, Eden Prairie, MN 55344 | Securities - Exemptions | 2020-05-15 ~ |
| Robert Edward Stone | 11995 Singletree Lane, Ste 500, Eden Prairie, MN 55344 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Daniel James Tangert | 6400 Fallbrook Rd., Eden Prairie, MN 55344 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Dmitry Bolkhovets | 11995 Singletree Ln, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Zinpro | 104000 Vikings Drive, Suite 240, Eden Prairie, MN 55344 | Commercial Feed | 2020-03-05 ~ 2020-12-31 |
| Michael Wallace Sentome | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Stephanie Denise Johnson | 8423 Cortland Rd, Eden Prairie, MN 55344 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Ashley Nicole Ingram | 11000 Optum Circle, Eden Prairie, MN 55344 | Registered Nurse | 2020-01-16 ~ 2020-08-31 |
| Colleen M Steven | 13900 Chestnut Drive # 208, Eden Prarie, MN 55344 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Rebecca Dipofi Rogers | 13625 Technology Dr, Eden Prairie, MN 55344 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Find all Licenses in zip 55344 | |||
| City | Eden Prairie |
| Zip Code | 55344 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Eden Prairie |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Scott K Sullivan Jr | 1717 Saint Charles Ave, New Orleans, LA 70130-5223 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Scott F Sullivan | 31 Walnut Road, Barrington, RI 02806 | Physician Assistant | 2009-06-17 ~ 2010-06-30 |
| James N Slater | 123 Sullivan St Apt 3, New York, NY 10012-3642 | Physician/surgeon | ~ |
| Paul C Sullivan | 8 Ash St, Nantucket, MA 02554-3517 | Physician/surgeon | 2018-10-01 ~ 2019-09-30 |
| Gail M Sullivan | 31 Old Johnson Rd, Durham, CT 06422 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Glenn H Segal | 46 Sullivan Rd, New Milford, CT 06776 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Richard L O'sullivan | 55 Bradley Rd, Madison, CT 06443-6606 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Rose M Tamura | 41 Sullivan Dr, Redding, CT 06896-2509 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Francis M Sullivan | 35 E View St, Warwick, RI 02888-1657 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Sahil Goyal | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | Physician/surgeon | ~ |
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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).