DERRICK P BROCKAMER (Credential# 1427044) is licensed (Physical Therapist) with Connecticut Department of Consumer Protection. The license effective date is February 1, 2020. The license expiration date date is January 31, 2021. The license status is ACTIVE.
DERRICK P BROCKAMER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #14.011681. The credential type is physical therapist. The effective date is February 1, 2020. The expiration date is January 31, 2021. The business address is 1 Balletto Dr, North Haven, CT 06473-3414. The current status is active.
| Licensee Name | DERRICK P BROCKAMER |
| Credential ID | 1427044 |
| Credential Number | 14.011681 |
| Credential Type | Physical Therapist |
| Business Address |
1 Balletto Dr North Haven CT 06473-3414 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-11-02 |
| Effective Date | 2020-02-01 |
| Expiration Date | 2021-01-31 |
| Refresh Date | 2020-03-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1429088 | 14.011392-TEMP | PT Temporary Permit | 2017-06-05 | 2017-06-05 - 2017-10-02 | INACTIVE |
| Street Address | 1 BALLETTO DR |
| City | NORTH HAVEN |
| State | CT |
| Zip Code | 06473-3414 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Renee A Rollier | 90 Fallon Drive, North Haven, CT 06473 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carly J Brueggestrat Aprn | 191 Cloudland Rd, North Haven, CT 06473 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Heesuk Hyun | 769 Middletown Ave, North Haven, CT 06473 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Jacqueline N Sancho | 9 Corey Rd, North Haven, CT 06473 | Physical Therapist Assistant | 2020-08-01 ~ 2021-07-31 |
| Irene L Smith | 35 Debra Lane, North Haven, CT 06473 | Radiographer | 2020-08-01 ~ 2021-07-31 |
| Jane S Jane | 380 Skiff Street, North Haven, CT 06473 | Psychologist | 2020-09-01 ~ 2021-08-31 |
| Shana Kathleen Lipp | [email protected], North Haven, CT 06473 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Haifeng Piao | 201 Universal Drive, North Haven, CT 06473 | Nail Technician | ~ |
| Xuefan Piao | 32 Lexington Gardens, North Haven, CT 06473 | Nail Technician | ~ |
| Zachary A Cuzzocreo | 45 Thorpe Street, North Haven, CT 06473 | Real Estate Salesperson | 2020-06-20 ~ 2021-05-31 |
| Find all Licenses in zip 06473 | |||
| City | NORTH HAVEN |
| Zip Code | 06473 |
| License Type | Physical Therapist |
| License Type + County | Physical Therapist + NORTH HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Derrick Brockamer | 19 Kensington Lane, Rocky Hill, CT 06067 | Medication Administration Certification | 2014-01-28 ~ 2016-01-27 |
| Robert L Smiley | 951 Derrick Adkins Ln, West Hempstead, NY 11552-3915 | Physical Therapist Assistant | 2019-02-01 ~ 2020-01-31 |
| Derrick A Hodges · Derrick Remodeling | 82 Plainfield St, Hartford, CT 06112 | Home Improvement Contractor | 2004-12-01 ~ 2005-05-20 |
| Marina Gabriella Brockamer | 1400 Hartford Tpke Apt 39, North Haven, CT 06473-2185 | Registered Nurse | ~ |
| Derrick Munro · Derrick's New England Painting | 267 Branford Rd Apt 106, North Branford, CT 06471-1330 | Home Improvement Contractor | 2012-02-01 ~ 2012-11-30 |
| Derrick's Remodeling LLC | 82 Plainfield St, Hartford, CT 06112 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Derrick W Kendrick | 2090 Stanley St Apt 200, New Britain, CT 06053-1558 | Massage Therapist | 2019-07-25 ~ 2021-06-30 |
| Derrick L Brown | 141 Newberry Road, East Haddam, CT 06423 | Massage Therapist | 1999-06-22 ~ 2000-03-31 |
| Koch Crane & Derrick Co. | 400 Roosevelt Ave, Carteret, NJ 07008 | Crane Registration | 1989-04-26 ~ 1990-04-25 |
| Hyundong Kim | CT | Physical Therapist | ~ |
Please comment or provide details below to improve the information on DERRICK P BROCKAMER.
| 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).