MICHAEL SUPRENANT PA-C (Credential# 1001927) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
MICHAEL SUPRENANT PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002584. The credential type is physician assistant. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 2 Eastview Dr, Simsbury, CT 06070-3010. The current status is active.
| Licensee Name | MICHAEL SUPRENANT PA-C |
| Credential ID | 1001927 |
| Credential Number | 23.002584 |
| Credential Type | Physician Assistant |
| Business Address |
2 Eastview Dr Simsbury CT 06070-3010 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2011-06-21 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-12-10 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1005179 | CSP.0050617 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2011-07-11 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 2 EASTVIEW DR |
| City | SIMSBURY |
| State | CT |
| Zip Code | 06070-3010 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Danielle Barone Suprenant | 2 Eastview Dr, Simsbury, CT 06070-3010 | Physical Therapist | 2020-09-01 ~ 2021-08-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Wanjin Kim | 4 Eastview Dr, Simsbury, CT 06070-3010 | Resident Dentist | 2019-07-01 ~ 2022-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Henry Withers | 571 Hopmeadow St, Simsbury, CT 06070 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Nancy W Flanagan | 9 Carver Circle, Simsbury, CT 06070 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Catharina A Bates | 12 East View Dr., Simsbury, CT 06070 | Real Estate Salesperson | 2020-06-25 ~ 2021-05-31 |
| Faith E Preato | 25 Squadron Line Rd, Simsbury, CT 06070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Diane Bragoni | 542 Hopmeadow Street, #128, Simsbury, CT 06070 | Architect | 2020-08-01 ~ 2021-07-31 |
| Virginia S Durst · Banks | 20 Woodcliff Drive, Simsbury, CT 06070 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Caitlin M Cornier | 18 Saxton Brook Drive, Simsbury, CT 06070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Nancy L Alleva · Maule | 1079 Hopmeadow St, Simsbury, CT 06070 | Respiratory Care Practitioner | 2020-09-01 ~ 2021-08-31 |
| Stephen R Birghenti · Simsbury Inn | 397 Hopmeadow St, Simsbury, CT 06070 | Hotel Liquor (50000 Or More Population) | 2019-08-14 ~ 2020-12-13 |
| Deborah L Poniatowski · Blase | 35 Munnisunk Dr, Simsbury, CT 06070 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06070 | |||
| City | SIMSBURY |
| Zip Code | 06070 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + SIMSBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lucille Suprenant | 84 Christian Hill, Brooklyn, CT 06234 | Family Child Care Assistant | 1997-01-31 ~ 1997-01-31 |
| Michael Moi | 85 Riverside Ave Apt G2, Stamford, CT 06905-4421 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Michael L Zande Pa | 31 Seymour St Ste 100, Hartford, CT 06106-5521 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Michael K Sullivan | 17 Sayles Ave, Lincoln, RI 02865-2133 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Michael C Korn Pa | 670 Whitney Ave, New Haven, CT 06511-1312 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Michael A Vargas Pa | 65 Trumbull Ave, Milford, CT 06460 | Physician Assistant | 2019-08-01 ~ 2020-07-31 |
| Michael G Chase | 399 Main Ave, Norwalk, CT 06851 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Michael Leonard Rubalsky | 76 Harold Dr, Newington, CT 06111-4220 | Physician Assistant | ~ |
| Michael J Strapp | Po Box 70772, Springfield, MA 01107-0772 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Michael N Luberti Pa | 18 Inwood Rd., Woodbridge, CT 06525 | Physician Assistant | 2020-09-01 ~ 2021-08-31 |
Please comment or provide details below to improve the information on MICHAEL SUPRENANT PA-C.
| 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).