VICTORIA M SULLIVAN (Credential# 1189437) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
VICTORIA M SULLIVAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003031. The credential type is physician assistant. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 93 Lacey Rd, Bethany, CT 06524-3021. The current status is active.
| Licensee Name | VICTORIA M SULLIVAN |
| Credential ID | 1189437 |
| Credential Number | 23.003031 |
| Credential Type | Physician Assistant |
| Business Address |
93 Lacey Rd Bethany CT 06524-3021 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2013-12-13 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-04-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1199316 | CSP.0056509 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-12-20 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 93 LACEY RD |
| City | BETHANY |
| State | CT |
| Zip Code | 06524-3021 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael P Sullivan | 93 Lacey Rd, Bethany, CT 06524-3037 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John Booss Md | 88 Lacey Rd, Bethany, CT 06524-3021 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Annette M Snow · Annette Paskiewicz | 54 Lacey Rd, Bethany, CT 06524-3021 | Dietitian/nutritionist | 2019-11-01 ~ 2020-10-31 |
| Erica L Di Leo | 41 Lacey Rd, Bethany, CT 06524-3021 | Emergency Medical Technician | 2013-04-23 ~ 2016-01-01 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Catherine M Ford · Porto | 78 Tuttle Court, Bethany, CT 06524 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Erin Mcknight | 24 Timber Ln, Bethany, CT 06524 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Cheryl A Bevvino | 106 Sperry Rd, Bethany, CT 06524 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Catherine Geloso | 19 Amadeo Drive, Bethany, CT 06524 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Patricia Burke | 12 Miller Rd, Bethany, CT 06524 | Veterinarian | 2020-09-01 ~ 2021-08-31 |
| Complete Excavating Services LLC | 674 Amity Rd, Bethany, CT 06524 | Demolition Contractor | 2020-07-01 ~ 2021-06-30 |
| Brian K Coutermarsh | 32 Emerald Lane, Bethany, CT 06524 | Radiographer | 2020-09-01 ~ 2021-08-31 |
| Michelle L Amato | 172 Russell Rd, Bethany, CT 06524 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Joseph L Colaci | 57 Edwards Road, Bethany, CT 06524 | Nursing Home Administrator | 2020-05-01 ~ 2022-04-30 |
| Karen C Praskievicz | 85 Sperry Rd, Bethany, CT 06524 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Find all Licenses in zip 06524 | |||
| City | BETHANY |
| Zip Code | 06524 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + BETHANY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Victoria Verrengia | 66 Montgomery Dr, Plymouth, MA 02360-5268 | Physician Assistant | ~ |
| Victoria K Smith Pa | 75 Railroad Ave Apt 2k, Milford, CT 06460-9206 | Physician Assistant | 2014-12-01 ~ 2015-11-30 |
| Victoria P Furnelli Pa | 104 Hillcrest Ave, Longmeadow, MA 01106 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Emily Warden | 137 Victoria Dr, Madison, AL 35758 | Physician Assistant | 2017-04-03 ~ 2018-04-30 |
| Sarah B Sullivan Pa-c | 113 Old Stratfield Rd, Fairfield, CT 06825 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Jill M Sullivan | 142 Bellridge Rd, Glastonbury, CT 06033-1462 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Michael K Sullivan | 17 Sayles Ave, Lincoln, RI 02865-2133 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Victoria L Maxwell Pa | 823 Williams Street, Pittsfield, MA 01201 | Physician Assistant | 2003-07-01 ~ 2004-06-30 |
| Teresa A Thetford Pa-c | 70 Victoria Lawn, Stratford, CT 06615-7849 | Physician Assistant | 2019-02-01 ~ 2020-01-31 |
| Debra M Sullivan Pa | 9 Clearview Dr, Sandy Hook, CT 06482 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on VICTORIA M SULLIVAN.
| 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).