MICHELLE L DAWICZYK (Credential# 1082316) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2014. The license expiration date date is March 31, 2015. The license status is INACTIVE.
MICHELLE L DAWICZYK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002808. The credential type is physician assistant. The effective date is April 1, 2014. The expiration date is March 31, 2015. The business address is 507 Cat Tail Ln, Manchester, CT 06042-7103. The current status is inactive.
Licensee Name | MICHELLE L DAWICZYK |
Credential ID | 1082316 |
Credential Number | 23.002808 |
Credential Type | Physician Assistant |
Business Address |
507 Cat Tail Ln Manchester CT 06042-7103 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 2012-09-06 |
Effective Date | 2014-04-01 |
Expiration Date | 2015-03-31 |
Refresh Date | 2015-07-06 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1124194 | CSP.0053755 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2012-09-21 | 2013-03-01 - 2015-02-28 | INACTIVE |
874598 | 71.000602 | Advanced Emergency Medical Technician | 2005-08-12 | 2009-11-10 - 2011-10-01 | INACTIVE |
845129 | 70.005396 | Emergency Medical Technician | 2004-09-28 | 2004-09-28 - 2006-07-01 | INACTIVE |
Street Address | 507 CAT TAIL LN |
City | MANCHESTER |
State | CT |
Zip Code | 06042-7103 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Yara Aljahlan | 501 Cat Tail Ln, Manchester, CT 06042-7103 | Speech and Language Pathologist | 2019-09-01 ~ 2020-08-31 |
Eric R Prause | 505 Cat Tail Ln, Manchester, CT 06042-7103 | Engineer-in-training | 2003-09-09 ~ 2013-09-09 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Melissa Aiello | 118 Tudor Lane Apt. I, Manchester, CT 06042 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
Michelle Carolyn Hayes | 129 Rachel Rd, Harford, CT 06042 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
Guotong Quan | 348 Kennedy Road, 348 Kennedy Road, CT 06042 | Nail Technician | 2020-06-26 ~ 2022-03-31 |
Charity Boakye | 103 Rachel Rd,unit B, Manchester, CT 06042 | Licensed Practical Nurse | ~ |
Jordan M Kaiser | 40 Tanner St, Manchester, CT 06042 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
Tandra Gomes | 80 Alton St., Manchester, CT 06042 | Medication Administration Certification | 2020-05-08 ~ 2022-05-07 |
James Power | 16 Lawton Rd., Manchester, CT 06042 | Medication Administration Certification | 2018-08-03 ~ 2020-08-02 |
Tierra Amerson | 66 Phelps Rd., Manchester, CT 06042 | Medication Administration Certification | 2018-07-02 ~ 2020-07-01 |
Lisa A Surdam | 22 Greenwood Drive, Manchester, CT 06042 | Notary Public Appointment | 2020-06-01 ~ 2025-05-31 |
Sharon Morin | 15 Hartland Rd, Manchester, CT 06042 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
Find all Licenses in zip 06042 |
City | MANCHESTER |
Zip Code | 06042 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + MANCHESTER |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Tara Michelle Laforge | 245 5th Ave, New York, NY 10016 | Physician Assistant | ~ |
Michelle Canning Pa | 9 Common Dr, W Hartford, CT 06107 | Physician Assistant | 2004-10-25 ~ 2005-11-30 |
Michelle Ana Figueroa | 26 Christopher Ter, West Springfield, MA 01089-4523 | Physician Assistant | ~ |
Brittany Michelle Wozniak | 80 Seymour St, Hartford, CT 06106-3315 | Physician Assistant | ~ |
Michelle Chiriani | 66 Westlake Dr, Thornwood, NY 10594 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
Michelle H Kwok | 169 South New Rd, Hamden, CT 06518 | Physician Assistant | 2008-06-17 ~ 2009-06-30 |
Michelle L Vogan Pa | 40 Prospect Ave Apt 1, Norwalk, CT 06850-3737 | Physician Assistant | 2008-10-28 ~ 2009-10-31 |
Michelle L Sabsels | 509 E 12th St Apt 2c, New York, NY 10009-3891 | Physician Assistant | 2005-09-01 ~ 2006-09-30 |
Michelle M James | 222 E 19th St, New York, NY 10003 | Physician Assistant | 2015-02-01 ~ 2016-01-31 |
Lina Michelle Weber | 245 5th Ave Floor 3, New York, NY 10016 | Physician Assistant | ~ |
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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).