ETHAN H LEVINE (Credential# 1426049) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2018. The license expiration date date is April 30, 2019. The license status is INACTIVE.
ETHAN H LEVINE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003863. The credential type is physician assistant. The effective date is May 1, 2018. The expiration date is April 30, 2019. The business address is 613 Jefferson Blvd, Fishkill, NY 12524-3916. The current status is inactive.
| Licensee Name | ETHAN H LEVINE |
| Credential ID | 1426049 |
| Credential Number | 23.003863 |
| Credential Type | Physician Assistant |
| Business Address |
613 Jefferson Blvd Fishkill NY 12524-3916 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2017-06-30 |
| Effective Date | 2018-05-01 |
| Expiration Date | 2019-04-30 |
| Refresh Date | 2019-08-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1467302 | CSP.0067232 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-12-18 | 2017-12-18 - 2019-02-28 | LAPSED |
| 1082980 | 70.015265 | Emergency Medical Technician | 2012-07-12 | 2014-12-04 - 2018-01-01 | INACTIVE |
| 1044166 | PTN.0013891 | PHARMACY TECHNICIAN | 2011-12-08 | 2013-04-01 - 2014-03-31 | INACTIVE |
| Street Address | 613 JEFFERSON BLVD |
| City | FISHKILL |
| State | NY |
| Zip Code | 12524-3916 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Stephen Herbert Hooper | 1505 Max Way, Fishkill, NY 12524 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Catherine Artigas | 4b Rosilia Ln, Fishkill, NY 12524 | Master's Level Social Worker | ~ |
| Bernard J Lanza | 105 Cherrywood Dr, Fishkill, NY 12524 | Architect | 2020-08-01 ~ 2021-07-31 |
| Jacqueline Ann Morris | 7 Rega Road, Fishkill, NY 12524 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Erica Palmiero | 21 Hilltop Circle, Fishkill, NY 12524 | Registered Nurse | 2020-04-17 ~ 2021-03-31 |
| Chelsea A Bera | 71 Lyndon Road, Fishkill, NY 12524 | Behavior Analyst | 2020-03-27 ~ 2021-01-31 |
| Georgia V Del Vecchio | 221 Smithtown Road, Fishkill, NY 12524 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Aaron Ulrich | 4 Locust Court, Fishkill, NY 12524 | Pharmacy Technician | 2020-04-01 ~ 2021-03-31 |
| Katrina Wuersching | 11 Field Court, Fishkill, NY 12524 | Licensed Practical Nurse | ~ |
| Mariam Soliman | 90 Watch Hill Drive, Fishkill, NY 12524 | Registered Nurse | ~ |
| Find all Licenses in zip 12524 | |||
| City | FISHKILL |
| Zip Code | 12524 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + FISHKILL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ethan Searles | 91 Poplar Ave, Bronx, NY 10465-3943 | Physician Assistant | 2017-01-01 ~ 2017-12-31 |
| Deena R Levine Pa | 193 Hamilton Ave Unit 19, Greenwich, CT 06830 | Physician Assistant | 2001-06-19 ~ 2002-08-31 |
| Levine & Levine Co Inc | 120 Lebanon Ave, Colchester, CT 06415 | Closing Out Sale | 1996-08-22 ~ 1996-11-22 |
| Ethan Lindberg Foundation, Inc. · Ethan Lindberg Foundation, Ethan M. Lindberg Foundation | 12254 Bellingham Road, Caledonia, IL 61011 | Public Charity | 2016-12-01 ~ 2017-11-30 |
| Kimberly D Levine | 27 Evergreen Terrace, Colchester, CT 06415 | Occupational Therapist Assistant | 2007-05-24 ~ 2009-07-31 |
| Heidi I Levine | 220 E 95th Street, Apt.3c, New York, NY 10128 | Physical Therapist Assistant | 2009-01-15 ~ 2010-01-31 |
| Ethan Allen Global Inc | Ethan Allen Dr, Danbury, CT 06813 | Sterilization Permit for Bedding & Upholstered Furniture | ~ |
| Rogelio R Rivera | 1038 Ethan Allen Drive, New Windsor, NY 12553 | Physical Therapist Assistant | 2020-03-01 ~ 2021-02-28 |
| Levine Distributing Co Inc | 15 Stott Ave, Norwich, CT 06360-1507 | Wholesale Liquor | 2020-07-22 ~ 2021-07-21 |
| Jennifer Levine | 45 Fairgrounds Road, Woodbridge, CT 06512 | Family Child Care Assistant | 2006-05-19 ~ |
Please comment or provide details below to improve the information on ETHAN H LEVINE.
| 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).