STEPHANIE A. BANACH
Dental Hygienist


Address: 310 Dickinson Hill Rd, Russell, MA 01071-9762

STEPHANIE A. BANACH (Credential# 1003182) is licensed (Dental Hygienist) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2015. The license expiration date date is December 31, 2015. The license status is INACTIVE.

Business Overview

STEPHANIE A. BANACH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #13.007773. The credential type is dental hygienist. The effective date is January 1, 2015. The expiration date is December 31, 2015. The business address is 310 Dickinson Hill Rd, Russell, MA 01071-9762. The current status is inactive.

Basic Information

Licensee Name STEPHANIE A. BANACH
Credential ID 1003182
Credential Number 13.007773
Credential Type Dental Hygienist
Business Address 310 Dickinson Hill Rd
Russell
MA 01071-9762
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2011-06-23
Effective Date 2015-01-01
Expiration Date 2015-12-31
Refresh Date 2016-04-04

Office Location

Street Address 310 DICKINSON HILL RD
City RUSSELL
State MA
Zip Code 01071-9762

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Eleanor A Blanchard 965 Blandford Road, Russell, MA 01071 Notary Public Appointment 2013-05-16 ~ 2018-05-31
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Raeven M Fuller 34 West Main St, Russell, MA 01071 Pharmacy Technician 2017-04-01 ~ 2018-03-31
Nicholas M. Langone 640 South Quarter Rd., Russell, MA 01071 Hoisting Equipment Operator 2016-03-04 ~ 2018-03-03
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Competitor

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City RUSSELL
Zip Code 01071
License Type Dental Hygienist
License Type + County Dental Hygienist + RUSSELL

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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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