BODHI M ANDERSON (Credential# 1334065) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is November 1, 2019. The license expiration date date is October 31, 2020. The license status is ACTIVE.
BODHI M ANDERSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003705. The credential type is physician assistant. The effective date is November 1, 2019. The expiration date is October 31, 2020. The business address is 100 Barenaba Ln, Hilo, HI 96720-4218. The current status is active.
| Licensee Name | BODHI M ANDERSON |
| Credential ID | 1334065 |
| Credential Number | 23.003705 |
| Credential Type | Physician Assistant |
| Business Address |
100 Barenaba Ln Hilo HI 96720-4218 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2016-10-03 |
| Effective Date | 2019-11-01 |
| Expiration Date | 2020-10-31 |
| Refresh Date | 2019-07-30 |
| Street Address | 100 BARENABA LN |
| City | HILO |
| State | HI |
| Zip Code | 96720-4218 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Donna Ching | 73 Puuhonu Place, Hilo, HI 96720 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Susan M Cauley | 1029 Ainako Ave, Hilo, HI 96720 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Jonathan Norio Kimura | 286 Kanoelani St, Hilo, HI 96720 | Engineer-in-training | 2001-03-13 ~ 2011-03-13 |
| Thomas G Kai | 131 Halai St, Hilo, HI 96720 | Engineer-in-training | ~ |
| Rena N Paopao | 582-b Kukuau St, Hilo, HI 96720 | Registered Nurse | 2000-05-19 ~ 2000-11-30 |
| Justin Akira Kimura | 286 Kanoelani St, Hilo, HI 96720 | Engineer-in-training | 1999-02-09 ~ 2009-02-09 |
| Karen Williams | Po Box 4262, Hilo, HI 96720-0262 | Registered Nurse - Temporary | 2009-09-18 ~ 2010-01-16 |
| Tara Braun | 25-53 Pukana La St, Hilo, HI 96720-1377 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Lisa M Fleury | 661 Kalanikoa St, Hilo, HI 96720-4558 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Waiakea Inc | 447 Kalanianaole Ave, Hilo, HI 96720-4772 | Non-alcoholic Beverage & Water Bottlers | 2019-11-07 ~ 2020-06-30 |
| Find all Licenses in zip 96720 | |||
| City | HILO |
| Zip Code | 96720 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + HILO |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Bodhi Naturopathic LLC | 81 Halls Rd Ste A, Old Lyme, CT 06371-4410 | Non Legend Drug Permit | 2015-04-21 ~ 2015-12-31 |
| Bodhi Supreme | Connecticut Brand Registration, Hartford, CT 06103 | Liquor Brand Label | 2018-07-30 ~ 2021-07-29 |
| Stacie B Campbell | 646 Anderson Ave., New York, NY 10024 | Physician Assistant | 2005-09-01 ~ 2006-09-30 |
| Katie Lynn Anderson | 15 Wiemes Ct, Waterford, CT 06385 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Darcy Anderson | 147 Hartford Ave, East Granby, CT 06026 | Physician Assistant | 1995-04-19 ~ 1996-06-30 |
| Deanne M Anderson | 154 Croyden Terrace, Springfield, MA 01104 | Physician Assistant | 1999-08-03 ~ 1999-10-31 |
| Erin R Anderson | 109 Highland Road, Stamford, CT 06902 | Physician Assistant | 2020-09-01 ~ 2021-08-31 |
| Larry A Anderson | 28 Spinning Wheel, Monroe, CT 06468 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Jakelinne E Caballero-asta | 26 Anderson Rd, Katonah, NY 10536-1128 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Physician Assistant Foundation of The American Academy of Physician Assistants | 2318 Mill Rd Ste 1300, Alexandria, VA 22314-6868 | Public Charity | 2019-12-01 ~ 2020-11-30 |
Please comment or provide details below to improve the information on BODHI M ANDERSON.
| 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).