SHANE L ELLSWORTH DMD (Credential# 704343) is licensed (Dentist) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2010. The license expiration date date is August 31, 2011. The license status is INACTIVE.
SHANE L ELLSWORTH DMD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #2.009891. The credential type is dentist. The effective date is September 1, 2010. The expiration date is August 31, 2011. The business address is 704 Ne Evans St, Mcminnville, OR 97128-3926. The current status is inactive.
| Licensee Name | SHANE L ELLSWORTH DMD |
| Credential ID | 704343 |
| Credential Number | 2.009891 |
| Credential Type | Dentist |
| Business Address |
704 Ne Evans St Mcminnville OR 97128-3926 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2008-06-18 |
| Effective Date | 2010-09-01 |
| Expiration Date | 2011-08-31 |
| Refresh Date | 2011-12-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 479716 | CSP.0042421 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-08-14 | 2009-03-01 - 2011-02-28 | INACTIVE |
| Street Address | 704 NE EVANS ST |
| City | MCMINNVILLE |
| State | OR |
| Zip Code | 97128-3926 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Maysara Winery LLC · Maysara Winery | 2083 Ne Colvin Court, Mcminnville, OR 97128 | Out of State Winery | 2019-07-25 ~ 2020-07-24 |
| Hazelwood Farms Bakeries | 2803 Orchard Ave, Mcminnville, OR 97128 | Bakery | 1999-08-04 ~ 2000-06-30 |
| Ann Sharon Ryan | 1602 Ne Riverside Dr, Mcminnville, OR 97128 | Registered Nurse | 2015-08-01 ~ 2016-07-31 |
| Alan D Russakov | 2700 Three Mile Lane, Mcminnville, OR 97128 | Physician/surgeon | 2000-05-16 ~ 2001-05-31 |
| Evergreen Agricultural Enterprises Inc | 3850 Three Mile Lane, Mcminnville, OR 97128 | Out of State Shipper Liquor | 2007-09-14 ~ 2008-09-13 |
| Stone Wolf Vineyards Inc · Wolf Vineyards | 105 West 3rd Street, Mcminnville, OR 97128 | Out of State Winery | 2002-05-24 ~ 2003-05-23 |
| Panther Creek Company | 455 North Irvine, Mcminnville, OR 97128 | Out of State Winery | 2004-09-30 ~ 2005-09-29 |
| Jean Ann Warden | 1301 Ne Highway 99w # 106, Mcminnville, OR 97128-2722 | Registered Nurse - Temporary | 2009-07-16 ~ 2009-11-13 |
| D & D Vineyards Inc · The Eyrie Vineyards | 935 Ne 10th Ave, Mcminnville, OR 97128-4003 | Out of State Shipper Liquor | 2020-02-23 ~ 2021-02-22 |
| A & D Wine Co · Westrey Wine Company | 1065 Ne Alpine Ave, Mcminnville, OR 97128-4013 | Out of State Winery | 2014-06-06 ~ 2015-06-05 |
| Find all Licenses in zip 97128 | |||
| City | MCMINNVILLE |
| Zip Code | 97128 |
| License Type | Dentist |
| License Type + County | Dentist + MCMINNVILLE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mr Shane's Ice Cream · Mr Shane's Homemade Parlour Ice Cream Inc | 409 Main St, Ridgefield, CT 06877 | Frozen Dessert Wholesaler | 2003-08-15 ~ 2003-12-31 |
| Shane Johnson · Shane's Replace & Remodel | 246 W Hill Rd, Torrington, CT 06790-4529 | Home Improvement Contractor | 2017-12-01 ~ 2018-11-30 |
| Shane Schmid · Shane's Handyman Services | 9 Park Rd. Unit B, Colchester, CT 06415 | Home Improvement Contractor | 2011-12-01 ~ 2012-11-30 |
| Shane M Kelly · Shane Kelly Painting | 645 Chestnut Hill Rd, Glastonbury, CT 06033 | Home Improvement Contractor | 2010-12-01 ~ 2011-11-30 |
| Shane C Perry · Shane Perry Sheetmetal | 150 Falls Rd, Bethany, CT 06524-3301 | Limited Sheet Metal Contractor | 2019-09-01 ~ 2020-08-31 |
| Dixon Shane LLC · R & S Northeast LLC | 8407 Austin Tracy Rd, Fountain Run, KY 42133-9606 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Shane Gordon · Shane Gordon Drywall | 281 Sargeant St, Hartford, CT 06105 | Home Improvement Contractor | 2015-12-01 ~ 2016-11-30 |
| Shane Michael Dunn · Shane Dunn | 515 Asylum St, Norwich, CT 06360-2619 | Home Improvement Contractor | 2020-02-26 ~ 2020-11-30 |
| Shane's Landscaping LLC | 19 Melrose Ave, Oakville, CT 06779 | Home Improvement Contractor | 2007-05-14 ~ 2007-11-30 |
| Jordan and Shane LLC | 75 Hastings Ln, Stamford, CT 06905-2902 | Home Improvement Contractor | ~ |
Please comment or provide details below to improve the information on SHANE L ELLSWORTH DMD.
| 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).