ERUM SHAHAB (Credential# 560694) 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.
ERUM SHAHAB is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.043112. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 80 Pinnacle Rd, Ellington, CT 06029-3510. The current status is active.
| Licensee Name | ERUM SHAHAB |
| Credential ID | 560694 |
| Credential Number | 1.043112 |
| Credential Type | Physician/Surgeon |
| Business Address |
80 Pinnacle Rd Ellington CT 06029-3510 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - PRIOR DISCIPLINE |
| Active | 1 |
| Issue Date | 2005-03-01 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-02-18 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 399731 | CSP.0037210 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-04-15 | 2017-03-01 - 2019-02-28 | INACTIVE |
| Street Address | 80 PINNACLE RD |
| City | ELLINGTON |
| State | CT |
| Zip Code | 06029-3510 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sayyeda M Hashmi | 80 Pinnacle Rd, Ellington, CT 06029-3510 | Occupational Therapist | 2010-11-05 ~ 2011-07-31 |
| Arthur F Barber | 80 Pinnacle Rd, Ellington, CT 06029 | Plumbing & Piping Limited Contractor | 2002-11-01 ~ 2003-10-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marcia D Chapman | 40 Pinnacle Rd, Ellington, CT 06029-3510 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Matthew M Mashayekhi | 74 Pinnacle Rd, Ellington, CT 06029-3510 | Emergency Medical Technician | 2013-06-19 ~ 2016-04-01 |
| Leonard Blazys | 78 Pinnacle Rd, Ellington, CT 06029-3510 | Milk Examiner | 2013-06-06 ~ 2015-06-05 |
| Todd E Stacy | 70 Pinnacle Rd, Ellington, CT 06029-3510 | Engineer-in-training | ~ |
| Pegeen L Sullivan | 72 Pinnacle Rd, Ellington, CT 06029-3510 | Nursing Home Administrator | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lisa M Houlihan | 42 Crane Road, Ellington, CT 06029 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Christine E Powers | 94 Abbott Road, Ellington, CT 06029 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Kathryn R Walker | 3 Maplewood Dr, Ellington, CT 06029 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Megan Elizabeth Knowling | 40 Ellridge Pl, Ellington, CT 06029 | Emergency Medical Technician | ~ |
| Elizabeth J Rhoads | 18 Crystal Ridge Dr., Ellington, CT 06029 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Nancy S Nicolescu | 21 Lake Street, Ellington, CT 06029 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Emily Albertson | 155 Windermere Ave #3005, Ellington, CT 06029 | Registered Nurse | ~ |
| Meghan Laughlan | 3 Crystal Ball Ct, Ellington, CT 06029 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carly A Havener | 187 Mountain Street, Ellington, CT 06029 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Carol G Aborn | 21 Upper Butcher Rd., Ellington, CT 06029 | Dental Hygienist | 2020-09-01 ~ 2021-08-31 |
| Find all Licenses in zip 06029 | |||
| City | ELLINGTON |
| Zip Code | 06029 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + ELLINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Erum Z Khan | 1821 Tremont Ct, Columbia, MO 65203-5473 | Physician/surgeon | 2015-05-01 ~ 2016-04-30 |
| Erum's One Stop · Snee Inc Dba | 81 Union St, Rockville, CT 06066 | Retail Gasoline Dealer | 2006-11-01 ~ 2007-10-31 |
| Erum's One Stop | 81 Union St, Rockville, CT 060666 | Operator of Weighing & Measuring Devices | 2007-08-01 ~ 2008-07-31 |
| Seyed Shahab Jazayeri Moghaddas | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-06-10 ~ 2022-06-21 |
| Shahab Raza | 5 Mist Ln, Westbury, NY 11590-6309 | Professional Engineer | 2016-02-01 ~ 2017-01-31 |
| Shahab U Ahmed | 240 Scott #2, Naugatuck, CT 06770 | Home Improvement Contractor | 2007-04-16 ~ 2007-11-30 |
| Shahab Khatami | 1700 Bristol Oaks Dr, Roswell, GA 30075-4181 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Zartashia Shahab | 92 Kaye Vue Dr Apt D, Hamden, CT 06514-2373 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Shumaila Erum | 100 Alexander Ave, Bridgeport, CT 06606-4413 | Registered Nurse | 2019-03-01 ~ 2020-02-29 |
| Erum Fatima | 121 Abbotsford Ave, West Hartford, CT 06110-2203 | Real Estate Salesperson | ~ |
Please comment or provide details below to improve the information on ERUM SHAHAB.
| 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).