DOUGLAS HICKOK (Credential# 1417781) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is February 1, 2019. The license expiration date date is January 31, 2020. The license status is ACTIVE.
DOUGLAS HICKOK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003836. The credential type is physician assistant. The effective date is February 1, 2019. The expiration date is January 31, 2020. The business address is Po Box 313, Bethel, PA 19507-0313. The current status is active.
| Licensee Name | DOUGLAS HICKOK |
| Credential ID | 1417781 |
| Credential Number | 23.003836 |
| Credential Type | Physician Assistant |
| Business Address |
Po Box 313 Bethel PA 19507-0313 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-05-18 |
| Effective Date | 2019-02-01 |
| Expiration Date | 2020-01-31 |
| Refresh Date | 2019-04-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1425506 | CSP.0065556 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-05-20 | 2017-05-20 - 2019-02-28 | LAPSED |
| Street Address | PO BOX 313 |
| City | BETHEL |
| State | PA |
| Zip Code | 19507-0313 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kenneth R Pletz | 201 Old Mountain Rd, Bethel, PA 19507 | Professional Engineer | 2005-02-01 ~ 2006-01-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Envirotech of Fairfield County Inc | 115 Wooster St, Bethel, CT 06801-1837 | Lead Consultant Contractor | 2020-08-01 ~ 2021-07-31 |
| John Anthony Dulko | 6 Winthrop Road, Bethel, CT 06801 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Nathalie A Morton | 100 Milwaukee Ave, Bethel, CT 06801-2232 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jolyne Dudics | 29 Long Meadow Ln, Bethel, CT 06801-2612 | Massage Therapist | 2020-07-01 ~ 2022-06-30 |
| Antonietta Sproviero-metaxas | 36 Quaker Ridge Road, Bethel, CT 06801 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Nicholas J Dipisa | 7 Hickok Ave, Bethel, CT 06801-1406 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Mark K Roos | 6 Crestview Road, Bethel, CT 06801 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Kaela R Herzog | 11 S Crossing Way, Bethel, CT 06801-1666 | Emergency Medical Technician | 2020-06-25 ~ 2022-03-31 |
| Giannino Nocera · Johnny�s Painting & Power Washing | 60 Natureview Trl, Bethel, CT 06801-1456 | Home Improvement Contractor | 2020-06-23 ~ 2020-11-30 |
| Gina Marie Romano | 3 Carriage Dr, Bethel, CT 06801-2905 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Find all Licenses in BETHEL | |||
| City | BETHEL |
| Zip Code | 19507 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + BETHEL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Audrey Douglas | 26 John St, Derby, CT 06418 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Douglas L Kugel Pa-c | 10 Merrick Ct, Brewster, NY 10509 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Lauren Sloss | 12 Douglas Dr, Cumberland, RI 02864-1519 | Physician Assistant | 2018-07-02 ~ 2019-06-30 |
| Laurel J Harlamoff | 30 Douglas Ave. #a, Stamford, CT 06906 | Physician Assistant | 2003-05-01 ~ 2004-05-31 |
| Douglas R Paragone | 18 Bretton Rd, West Hartford, CT 06119 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Douglas R Hood Pa | 169 Ridgewood Ave, North Haven, CT 06473 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Sam Taylor Pa | 95169 Douglas Rd, Fernandina Beach, FL 32034-1268 | Physician Assistant | 2014-08-01 ~ 2015-07-31 |
| Douglas E Muller | 61-72 77th Street, Middle Village, NY 11379 | Physician Assistant | 2000-03-27 ~ 2001-02-28 |
| Juliane Laine Douglas | Naval Health Clinic Hawaii, Jbphh, HI 96860 | 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 |
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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).