MELISSA SHAW PA (Credential# 742421) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
MELISSA SHAW PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000672. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 210 Chaffinch Island Rd, Guilford, CT 06437. The current status is active.
| Licensee Name | MELISSA SHAW PA |
| Credential ID | 742421 |
| Credential Number | 23.000672 |
| Credential Type | Physician Assistant |
| Business Address |
210 Chaffinch Island Rd Guilford CT 06437 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1997-08-08 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-03-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 187990 | CSP.0026231 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 865821 | 70.940040 | Emergency Medical Technician | 1993-08-01 | - 1995-12-31 | INACTIVE |
| Street Address | 210 CHAFFINCH ISLAND RD |
| City | GUILFORD |
| State | CT |
| Zip Code | 06437 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John D Shaw | 210 Chaffinch Island Rd, Guilford, CT 06437-3207 | Certified Public Accountant License | 2020-01-01 ~ 2020-12-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jane E Olsen | Po Box 601, Guilford, CT 06437 | Real Estate Salesperson | 2020-06-27 ~ 2021-05-31 |
| Alanna Munzenmaier | 81 Saw Mill Rd, Guilford, CT 06437 | Veterinarian | 2020-07-01 ~ 2021-06-30 |
| Sandra L Lion | 84 Granite Road, Guilford, CT 06437 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| Nimet H Memik-moavero | 110 Cherry Street, Guilford, CT 06437 | Real Estate Salesperson | ~ |
| Jacklyn Nicole Basilicato | 345 Saw Mill Road, Guilford, CT 06437 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Alissa Bailey | 5 Streamview Circle, Guilford, CT 06437 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| The Marketplace Emporia LLC · The Marketplace Emporia, LLC | 77-79 Whitfield Street, Guilford, CT 06437 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Deborah Ackles | 46clear Lake Manor Road, Guilford, CT 06437 | Veterinarian | 2020-08-01 ~ 2021-07-31 |
| Bruce D Mccann | 200 State St, Guilford, CT 06437 | Architect | 2020-08-01 ~ 2021-07-31 |
| Stephanie J Jacobs | 130 Winthrop Rd, Guilford, CT 06437 | Real Estate Salesperson | 2020-06-25 ~ 2021-05-31 |
| Find all Licenses in zip 06437 | |||
| City | GUILFORD |
| Zip Code | 06437 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + GUILFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sarah B Asher | 4 Shaw's Cove, New London, CT 06320 | Physician Assistant | 2002-06-20 ~ 2002-12-31 |
| Melissa Lemiech | P. O. Box 142, Somers, CT 06071 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Deanna M Locurto | 18 Melissa Ln, Prospect, CT 06712-1462 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Melissa M Lariviere Pa | 39 Pervier Ave, Chicopee, MA 01020-4445 | Physician Assistant | 2010-09-27 ~ 2011-07-31 |
| Melissa Pelton | 89 Mohawk St, Stratford, CT 06614 | Physician Assistant | 2008-03-21 ~ 2009-05-31 |
| Melissa Acquaviva D'amato | 44 Cheltenham Way, Avon, CT 06001 | Physician Assistant | ~ |
| Melissa Smirnow | 205 10th St, Jersey City, NJ 07302 | Physician Assistant | ~ |
| Melissa L Marion Pa | 64 Robbins St, Waterbury, CT 06708-2613 | Physician Assistant | 2005-10-04 ~ 2006-07-31 |
| Melissa A Miller | 174 Krystyna Lane, Jordan, NY 13080 | Physician Assistant | 2005-07-01 ~ 2006-07-31 |
| Melissa A Perregaux | 220 Fairview Road, Westbrook, CT 06498 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
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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).