RANDY L PANKE (Credential# 1176579) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
RANDY L PANKE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003017. The credential type is physician assistant. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 2904 Seth Williams Blvd, Camp Lejeune, NC 28547-1401. The current status is active.
| Licensee Name | RANDY L PANKE |
| Credential ID | 1176579 |
| Credential Number | 23.003017 |
| Credential Type | Physician Assistant |
| Business Address |
2904 Seth Williams Blvd Camp Lejeune NC 28547-1401 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2013-10-23 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 2015939 | CSP.0073344 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2020-03-11 | 2020-03-11 - 2021-02-28 | ACTIVE |
| 1198858 | CSP.0056502 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-12-17 | 2015-03-01 - 2017-02-28 | INACTIVE |
| Street Address | 2904 SETH WILLIAMS BLVD |
| City | CAMP LEJEUNE |
| State | NC |
| Zip Code | 28547-1401 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Chelsea R Tokarz | 5182 Colorado Ave, Camp Lejeune, NC 28547 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Margaret Harvey | 100 Brewster Blvd, Camp Lejeune, NC 28547 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Jodi L Suares | 3302 Cooper Street, Camp Lejeune, NC 28547 | Emergency Medical Technician | 2004-12-29 ~ 2007-10-01 |
| Barry M Kilfoil | Naval Dental Center, Camp Lejeune, NC 28547 | Dentist | 1994-11-28 ~ 1995-11-30 |
| Brigita S Baumgardner | 5036 Alabama Ave, Camp Lejeune, NC 28547-1106 | Licensed Clinical Social Worker | 2012-07-01 ~ 2013-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paul J Brabham | Moq, Camp Lejeune, NC 28542 | Engineer-in-training | 1986-06-10 ~ 1996-06-10 |
| City | CAMP LEJEUNE |
| Zip Code | 28547 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + CAMP LEJEUNE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Randy L Champagne | 10 Briarwood Ln, Durham, CT 06422-1219 | Occupational Therapist Assistant | 2017-08-01 ~ 2019-07-31 |
| Randy W Mitchell | 19 Beckwith Drive, Plainville, CT 06062 | Occupational Therapist Assistant | 1999-07-02 ~ 2001-07-31 |
| Randy E Eskenazi | 36 Chalburn Road, Redding, CT 06896 | Physical Therapist Assistant | 2020-02-01 ~ 2021-01-31 |
| Randy Nyborg | 21 Carol Dr, Plainville, CT 06062 | Home Improvement Contractor | ~ 1995-10-01 |
| Randy H Cremasco · Randy's Painting & Remodeling | 18 Field St, Torrington, CT 06790 | Home Improvement Contractor | 1998-12-04 ~ 1999-11-30 |
| Randy Leary | P.o. Box 2227, Meriden, CT 06450 | Family Child Care Assistant | 1997-03-31 ~ 1997-03-31 |
| Randy Wetmore | 102 Dale Dr., Milford, CT 06461 | Family Child Care Assistant | 2009-02-09 ~ 2009-01-31 |
| Emily C Panke | 4 St. Michael's Lane, Paget, B2 PG 04 | Registered Nurse | 2019-08-01 ~ 2020-07-31 |
| Claire M Panke | 26 Cornelia Street, New York, NY 10014 | Registered Nurse | 2003-03-06 ~ 2004-03-31 |
| Randy S Heckman · Randy S Heckman Const | 727 Avery St, South Windsor, CT 06074 | Home Improvement Contractor | 2017-12-01 ~ 2018-11-30 |
Please comment or provide details below to improve the information on RANDY L PANKE.
| 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).