SHANNON MAXON PA (Credential# 742970) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is ACTIVE.
SHANNON MAXON PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001221. The credential type is physician assistant. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 33 Cosey Beach Ave, East Haven, CT 06512-4905. The current status is active.
| Licensee Name | SHANNON MAXON PA |
| Credential ID | 742970 |
| Credential Number | 23.001221 |
| Credential Type | Physician Assistant |
| Business Address |
33 Cosey Beach Ave East Haven CT 06512-4905 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2002-08-02 |
| Effective Date | 2020-08-01 |
| Expiration Date | 2021-07-31 |
| Refresh Date | 2020-06-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 316457 | CSP.0032628 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2002-08-16 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 33 COSEY BEACH AVE |
| City | EAST HAVEN |
| State | CT |
| Zip Code | 06512-4905 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| 1 Source Builders LLC · Home Renovation | 33 Cosey Beach Ave, East Haven, CT 06514 | Home Improvement Contractor | 2003-12-01 ~ 2004-11-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marisa E Grillo · Beach Head | 3 Cosey Beach Ave, East Haven, CT 06512-4905 | Restaurant Liquor | 2017-04-23 ~ 2018-04-18 |
| Michael L Romei · Beachhead Restaurant | 3 Cosey Beach Ave, East Haven, CT 06512-4905 | Restaurant Liquor | 2015-04-28 ~ 2016-04-27 |
| Barbara M Bucci · Beachhead Restaurant | 3 Cosey Beach Ave, East Haven, CT 06512-4905 | Restaurant Liquor | 2013-07-28 ~ 2014-07-27 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| East Haven Police Union Local #1662 | Po Box 120033, East Haven, CT 06512 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Danielle M Verderame | 66 Maple Street, East Haven, CT 06512 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Judith M Lyon · Sousa | 440 Townsend Ave, New Haven, CT 06512 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Toni Louise Montuori | 44 Francis St, East Haven, CT 06512 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Marcos E Zambrano | 17 Morse Place, New Haven, CT 06512 | Real Estate Salesperson | ~ |
| Nha H Lam | 274 Chidsey Ave, East Haven, CT 06512 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2021-07-31 |
| Niraliben N Patel | 44 Columbus Ave, East Haven, CT 06512 | Esthetician | ~ |
| Alyssa C Zordan | 65 Francis Street, East Haven, CT 06512 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Gomes Cleaning & Painting LLC | 296 Burr St, New Haven, CT 06512 | Home Improvement Contractor | 2020-06-18 ~ 2020-11-30 |
| Keith Bouve · Residential Restorations | 99 Prospect Rd, East Haven, CT 06512 | Home Improvement Contractor | 2020-06-24 ~ 2020-11-30 |
| Find all Licenses in zip 06512 | |||
| City | EAST HAVEN |
| Zip Code | 06512 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + EAST HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Antonia C Brancia Maxon · Maxon | 131 Chaffeeville Rd, Mansfield Center, CT 06250 | Audiologist | 2007-01-17 ~ 2008-03-31 |
| Shannon C Berger | 9 Colony Dr, Winsted, CT 06098 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Shannon Brigham | 41 Stanie Brae Dr, Watchung, NJ 07069-6231 | Physician Assistant | ~ |
| Shannon C Blake Pa | 1217 Tidalwalk Dr, Wilmington, NC 28409 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Shannon Carroll | 184 Summer St Apt 1610, Stamford, CT 06901-2352 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Shannon Lambert | 96 Corey Colonial, Agawam, MA 01001-2749 | Physician Assistant | 2011-12-01 ~ 2012-11-30 |
| Shannon Gorton | 2800 Main St, Bridgeport, CT 06606-4201 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Erin Kate Shannon | 3240 Monroe Ave, Rochester, NY 14618 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Shannon Marie Keohane | 2655 Northwinds Pkwy, Alpharetta, GA 30009-2280 | Physician Assistant | 2020-09-01 ~ 2021-08-31 |
| Domaine Des Gerbaux Maxon Chaintre | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2004-03-22 ~ 2007-03-21 |
Please comment or provide details below to improve the information on SHANNON MAXON PA.
| 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).