STACY SLAT (Credential# 937608) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is November 1, 2018. The license expiration date date is October 31, 2019. The license status is INACTIVE.
STACY SLAT is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.048977. The credential type is physician/surgeon. The effective date is November 1, 2018. The expiration date is October 31, 2019. The business address is 6804 Brandywine Ct, Fairview Heights, IL 62208. The current status is inactive.
| Licensee Name | STACY SLAT |
| Credential ID | 937608 |
| Credential Number | 1.048977 |
| Credential Type | Physician/Surgeon |
| Business Address |
6804 Brandywine Ct Fairview Heights IL 62208 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2010-07-08 |
| Effective Date | 2018-11-01 |
| Expiration Date | 2019-10-31 |
| Refresh Date | 2020-02-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 446867 | CSP.0040220 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-08-24 | 2008-04-04 - 2009-02-28 | INACTIVE |
| Street Address | 6804 Brandywine Ct |
| City | Fairview Heights |
| State | IL |
| Zip Code | 62208 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ceslee Nicole Wiley | 328 Countryside Lane, Fairview Heights, IL 62208 | Registered Nurse | 2018-05-01 ~ 2019-04-30 |
| Rhondalyn Burgett | 320 Veach Drive, Fairview Heights, IL 62208 | Respiratory Care Practitioner | 2010-11-01 ~ 2011-03-31 |
| Jennifer L Ward | 9737 N. Holy Cross Road, Fairview Heights, IL 62208 | Registered Nurse | 2009-11-06 ~ 2010-06-30 |
| Marsha T Powe · Satinoff | 107 Mark Drive, Fairview Heights, IL 62208 | Hairdresser/cosmetician | 2004-02-03 ~ 2005-12-31 |
| National Foundation for Ectodermal Dysplasias | 6 Executive Dr Ste 2, Fairview Heights, IL 62208-1360 | Public Charity | 2019-12-01 ~ 2020-11-30 |
| Ashley Rocio Sanders | 819 Foxgrove Dr, Fairview Heights, IL 62208-2095 | Registered Nurse | 2017-07-01 ~ 2018-06-30 |
| Tracey M Farmer Luster | 512 Joseph Dr, Fairview Heights, IL 62208-3617 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| David L Hosea | 208 Winchester Pl, Fairview Heights, IL 62208-3831 | Public Service Technician - Telephone | 2008-10-28 ~ 2009-09-30 |
| City | Fairview Heights |
| Zip Code | 62208 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Fairview Heights |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Stacy L Spooner Md | 8-1 Riverdale Landing, Old Lyme, CT 06371 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Stacy D Lundin Md | 35 Tannery Court, Glastonbury, CT 06033 | Physician/surgeon | 2002-01-02 ~ 2002-12-31 |
| Stacy B Gross | 5867 Sandstone Way, Jacksonville, FL 32258 | Physician/surgeon | 2008-01-09 ~ 2009-01-31 |
| Stacy J Spiro Md | 49 Pheasant Chase, West Hartford, CT 06117-1031 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Pamela Stacy Westerling | 14723 Hidden Meadows Dr, Dubuque, IA 52002 | Physician/surgeon | 2018-11-20 ~ 2019-08-31 |
| Stacy J Taylor | Hartford Healthcare Medical Group, Torrington, CT 06790 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| David F Slat Md | 211 Pomeroy Avenue Apartment 1415, Meriden, CT 06450 | Controlled Substance Registration for Practitioner | 2009-09-28 ~ 2011-02-28 |
| Stacy O Wilson · Stacy Wilson | 219 Indian Hollow Rd, Windham, CT 06280 | Home Improvement Contractor | 1998-10-02 ~ 1998-11-30 |
| Stacy Alston · Stacy Cakes LLC | 53 Wig Hill Rd, Chester, CT 06412-1111 | Cottage Food Operation | 2019-12-20 ~ 2021-02-28 |
| Stacy C Brown | 275 Winchester Ave, New Haven, CT 06511 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
Please comment or provide details below to improve the information on STACY SLAT.
| 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).