KATIE A COPPOLA (Credential# 1301759) 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.
KATIE A COPPOLA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003473. The credential type is physician assistant. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 288 Haddam Quarter Rd, Durham, CT 06422-1618. The current status is active.
| Licensee Name | KATIE A COPPOLA |
| Credential ID | 1301759 |
| Credential Number | 23.003473 |
| Credential Type | Physician Assistant |
| Business Address |
288 Haddam Quarter Rd Durham CT 06422-1618 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-11-09 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-04-07 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1320336 | CSP.0061748 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2015-11-11 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 288 HADDAM QUARTER RD |
| City | DURHAM |
| State | CT |
| Zip Code | 06422-1618 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| William Kovacs | 288 Haddam Quarter Rd, Durham, CT 06422 | Real Estate Salesperson | 2017-06-01 ~ 2018-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kathleen Canestrari | 206 Haddam Quarter Rd, Durham, CT 06422-1618 | Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jonathan A Luysterborghs | 208 Blue Hills Road, Durham, CT 06422 | Licensed Clinical Social Worker | 2020-08-01 ~ 2021-07-31 |
| Trinh Tu Tran | 10 Cesca Lane, Durham, CT 06422 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Beseck Mountain Rescue Inc | 68r Middlefield Road, Durham, CT 06422 | Public Charity-exempt From Financial Requirements | 2007-10-15 ~ |
| Mary E Gossart | 35 Maiden Lane, Durham, CT 06422 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Jayshreebahen Bidja · Little Rooster Liquors | 363 Main St, Durham, CT 06422 | Package Store Liquor | 2020-08-09 ~ 2021-08-08 |
| Erica Espinoza | 163 Stage Coach Rd, Durham, CT 06422 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Adrienne Lynn Deschnow | 419 R Johnson Lane, Durham, CT 06422 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Lynda S Collins · Robison | 649 Wallingford Road, Durham, CT 06422 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Pierino Peter Cascini | 425 Main Street, Durham, CT 06422 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Leila K Markunas | 250 Skeetclub Road, Durham, CT 06422 | Massage Therapist | 2020-09-01 ~ 2022-08-31 |
| Find all Licenses in zip 06422 | |||
| City | DURHAM |
| Zip Code | 06422 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + DURHAM |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Katie S Kwok Pa-c | 177 Judson Rd, Fairfield, CT 06824 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Katie L Merithew | 10 Phelps Dr, Hamden, CT 06514 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Katie M Roach | 3 David Drive, Simsbury, CT 06070 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Katie Lynn Anderson | 15 Wiemes Ct, Waterford, CT 06385 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Katie J Arey | 9 Cobblestone Dr, Broad Brook, CT 06016-1200 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Katie Lynn Tichenor | 2 Ross Passway, Morris, CT 06763-1300 | Physician Assistant | 2016-11-01 ~ 2017-10-31 |
| Katie Lynn Scott | 5717 Pacific Center Blvd, San Diego, CA 92121-4250 | Physician Assistant | 2020-01-01 ~ 2020-12-31 |
| Joseph S Coppola Jr · Coppola Enterprises | 27 King St, Danbury, CT 06811 | Home Improvement Contractor | 2013-12-11 ~ 2014-11-30 |
| Coppola Properties Inc | 927 Westover Road, Stamford, CT 06907 | New Home Construction Contractor | 1999-10-14 ~ 2001-09-30 |
| Emilio Coppola · Coppola & Sons Constr Co Inc | 74 Old Mill Ln, Stamford, CT 06902 | Home Improvement Contractor | ~ 1996-08-01 |
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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).