JAMES E. DETRICK (Credential# 1038604) is licensed (Physician Assistant) 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.
JAMES E. DETRICK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002705. The credential type is physician assistant. The effective date is May 1, 2016. The expiration date is April 30, 2017. The business address is 12410 Milestone Center Dr Ste 225, Germantown, MD 20876-7101. The current status is inactive.
| Licensee Name | JAMES E. DETRICK |
| Credential ID | 1038604 |
| Credential Number | 23.002705 |
| Credential Type | Physician Assistant |
| Business Address |
12410 Milestone Center Dr Ste 225 Germantown MD 20876-7101 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2012-01-12 |
| Effective Date | 2016-05-01 |
| Expiration Date | 2017-04-30 |
| Refresh Date | 2017-08-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1045232 | CSP.0051818 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2012-02-03 | 2015-03-01 - 2017-02-28 | INACTIVE |
| Street Address | 12410 MILESTONE CENTER DR STE 225 |
| City | GERMANTOWN |
| State | MD |
| Zip Code | 20876-7101 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Donald W Augustin | 12410 Milestone Center Dr Ste 225, Germantown, MD 20876-7103 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Derek S Wolfe | 12410 Milestone Center Dr Ste 225, Germantown, MD 20876-7101 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| James P Mcquiston | 12410 Milestone Center Dr Ste 225, Germantown, MD 20876-7101 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Michael G Cetta Md | 12410 Milestone Center Dr Ste 225, Germantown, MD 20876-7101 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Aaron M. Snyder Md | 12410 Milestone Center Dr Ste 225, Germantown, MD 20876-7101 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Noah L Keller | 12410 Milestone Center Dr Ste 225, Germantown, MD 20876-7101 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Lisa Hockman | 12410 Milestone Center Dr Ste 225, Germantown, MD 20876-7103 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| David N Klein Md | 12410 Milestone Center Dr Ste 225, Germantown, MD 20876-7101 | Controlled Substance Registration for Practitioner | 2015-06-19 ~ 2017-02-28 |
| Jesse J Irwin | 12410 Milestone Center Dr Ste 225, Germantown, MD 20876-7101 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Scot A Millay | 12410 Milestone Center Dr Ste 225, Germantown, MD 20876-7101 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Roger Dale Parker | 20501 Seneca Meadows Parkway, Germantown, MD 20876 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Angelo L Falcone Md | 12410 Milestone Ctre Dr, Germantown, MD 20876 | Physician/surgeon | 2016-08-01 ~ 2017-07-31 |
| Ishrat Khatri | 12410 Milestone Center Drive, Germantown, MD 20876 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Jamila Pennyman | 20408 Honey Crisp Lane, Germantown, MD 20876 | Registered Nurse | 2008-08-01 ~ 2009-06-30 |
| Wanda B Robinson | 21113 Kaul Lane, Germantown, MD 20876 | Registered Nurse | 1993-01-25 ~ 1994-03-31 |
| Benjamin M Holquist | 25 Observation Ct, Germantown, MD 20876 | Registered Nurse | 1997-04-23 ~ 1998-05-31 |
| Joanne S Boyce | 19804 Sovereign Ct, Germantown, MD 20876 | Dental Hygienist | 1995-01-03 ~ 1995-09-30 |
| Bennett V Boccuzzi | 11513 Scottsbury Ter, Germantown, MD 20876 | Registered Nurse | 2004-06-07 ~ 2005-07-31 |
| Kim-loan T Dinh | 11901 Isen Manor Drive, Germantown, MD 20876 | Hairdresser/cosmetician | 2004-07-19 ~ 2006-07-31 |
| Karen M Meade · King | 21113 Hickory Forest Way, Germantown, MD 20876 | Registered Nurse | 2004-09-27 ~ 2005-10-31 |
| Find all Licenses in zip 20876 | |||
| City | GERMANTOWN |
| Zip Code | 20876 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + GERMANTOWN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| James H Brown | 11-c Cos Cob Ave, Cos Cob, CT 06807 | Physician Assistant | 2005-11-15 ~ 2006-11-30 |
| James R Gerace Pa | 5 Upland Rd, Middlebury, CT 06762 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| James Alsup | 190 Woosamonsa Rd, Pennington, NJ 08534-4002 | Physician Assistant | 2001-08-30 ~ 2002-09-30 |
| James J Ryan | P.o. Box 525, Pine Plains, NY 12567 | Physician Assistant | 2003-03-03 ~ 2004-02-29 |
| James C. Bigham | 45 Frisbie St, Stamford, CT 06906-2018 | Physician Assistant | 2013-10-01 ~ 2014-10-31 |
| James E Scliopou Pa-c | 20 Carla Ln, Wilbraham, MA 01095-1454 | Physician Assistant | 2019-11-01 ~ 2020-10-31 |
| Michelle M James | 222 E 19th St, New York, NY 10003 | Physician Assistant | 2015-02-01 ~ 2016-01-31 |
| James B Hulin | 40 Prospect, Norwalk, CT 06850 | Physician Assistant | ~ 1996-06-30 |
| James P De Bay Jr. | 2116 Bigelow Commons, Enfield, CT 06082 | Physician Assistant | 1997-02-10 ~ 1998-04-30 |
| James P Brown Pa | 50 Black Walnut Dr, Middletown, CT 06457 | Physician Assistant | 2005-05-05 ~ 2006-05-31 |
Please comment or provide details below to improve the information on JAMES E. DETRICK.
| 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).