RUSSELL D TANNER RN
Registered Nurse


Address: 35 Admirals Dr E, Bay Shore, NY 11706-8102

RUSSELL D TANNER RN (Credential# 890473) is licensed (Registered Nurse) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2016. The license expiration date date is April 30, 2017. The license status is INACTIVE.

Business Overview

RUSSELL D TANNER RN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #10.090163. The credential type is registered nurse. The effective date is May 1, 2016. The expiration date is April 30, 2017. The business address is 35 Admirals Dr E, Bay Shore, NY 11706-8102. The current status is inactive.

Basic Information

Licensee Name RUSSELL D TANNER RN
Credential ID 890473
Credential Number 10.090163
Credential Type Registered Nurse
Business Address 35 Admirals Dr E
Bay Shore
NY 11706-8102
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2009-08-06
Effective Date 2016-05-01
Expiration Date 2017-04-30
Refresh Date 2018-03-13

Office Location

Street Address 35 Admirals Dr E
City BAY SHORE
State NY
Zip Code 11706-8102

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Joseph Marino 2 Pinebrook Place, Bay Shore, NY 11706 Notary Public Appointment 2001-08-23 ~ 2006-08-31
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Competitor

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City BAY SHORE
Zip Code 11706
License Type Registered Nurse
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Dataset Information

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).

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