JENNIFER K FAN MD (Credential# 556943) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2020. The license expiration date date is December 31, 2020. The license status is ACTIVE.
JENNIFER K FAN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.039357. The credential type is physician/surgeon. The effective date is January 1, 2020. The expiration date is December 31, 2020. The business address is Advanced Radiology, Shelton, CT 06484. The current status is active.
| Licensee Name | JENNIFER K FAN MD |
| Credential ID | 556943 |
| Credential Number | 1.039357 |
| Credential Type | Physician/Surgeon |
| Business Address |
Advanced Radiology Shelton CT 06484 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2001-03-20 |
| Effective Date | 2020-01-01 |
| Expiration Date | 2020-12-31 |
| Refresh Date | 2019-10-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 475878 | CSP.0041713 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-07-09 | 2013-03-01 - 2015-02-28 | INACTIVE |
| Street Address | ADVANCED RADIOLOGY |
| City | SHELTON |
| State | CT |
| Zip Code | 06484 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ruben Kier Md | Advanced Radiology, Shelton, CT 06484 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Scott J Kudravy | 2a Garden Ter, Shelton, CT 06484 | Radiographer | 2020-08-01 ~ 2021-07-31 |
| Melissa E Filanowski | 265 Mohegan Rd, Shelton, CT 06484 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Danuta Adamson · Chmiel | 101 Dickinson Drive, Shelton, CT 06484 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Sandra E Mercier | 234 Deer Run, Huntington, CT 06484 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Ping Li | 17 Coram Rd 3c, Shelton, CT 06484 | Nail Technician | ~ |
| Victoria Mary Bucci | 53 Isinglass Rd, Shelton, CT 06484 | Master's Level Social Worker | ~ |
| Samuel L Smith | 122 Maple Avenue, Shelton, CT 06484 | Dietitian/nutritionist | 2020-08-01 ~ 2021-07-31 |
| Cindy Hubbell Vidal | 17 Sherwood Lane, Shelton, CT 06484 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Rosa Conners | 189 Coram Avenue, Shelton, CT 06484 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Erica Azzarito | 40 Clinton Drive, Shelton, CT 06484 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| Find all Licenses in zip 06484 | |||
| City | SHELTON |
| Zip Code | 06484 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + SHELTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jennifer L Yeh Md | 4 Smith Dr, Savannah, GA 31406-6441 | Physician/surgeon | 2012-12-01 ~ 2013-11-30 |
| Jennifer H. Kuo | 161 Fort Washington Ave Fl 8, New York, NY 10032-3729 | Physician/surgeon | ~ |
| Jennifer Lax Md | 23 Old Stone Bridge Rd, Cos Cob, CT 06807-1511 | Physician/surgeon | 2003-05-16 ~ 2004-02-29 |
| Jennifer L Bau | 1 Guthrie Sq, Sayre, PA 18840-1625 | Physician/surgeon | 2017-03-01 ~ 2018-02-28 |
| Jennifer R Lee Md | 85 Viscount Dr#8c, Milford, CT 06460 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Jennifer F Cross | 19 W Brookside Dr, Larchmont, NY 10538 | Physician/surgeon | 1992-03-24 ~ 1993-02-28 |
| Jennifer Mcniff | 35 Marshall Ave, Guilford, CT 06437 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Jennifer J Wheler | 33 Hubinger St, New Haven, CT 06511-4034 | Physician/surgeon | 2005-05-31 ~ 2006-05-31 |
| Jennifer Mcquiston | 23134 Newcut Rd, Clarksburg, MD 20871-9377 | Physician/surgeon | ~ |
| Jennifer Rebecca Hill | 51-53 Kenosia Ave, Danbury, CT 06810 | Physician/surgeon | ~ |
Please comment or provide details below to improve the information on JENNIFER K FAN MD.
| 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).