RUSSELL LONGENDORFER (Credential# 1440614) 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.
RUSSELL LONGENDORFER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003945. The credential type is physician assistant. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 8 Alana Drive, Sutton, MA 01590. The current status is active.
| Licensee Name | RUSSELL LONGENDORFER |
| Credential ID | 1440614 |
| Credential Number | 23.003945 |
| Credential Type | Physician Assistant |
| Business Address |
8 Alana Drive Sutton MA 01590 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-09-08 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-03-16 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1440769 | CSP.0066497 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-09-09 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 8 Alana Drive |
| City | Sutton |
| State | MA |
| Zip Code | 01590 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Scott H Paul | 309 Mendon Rd, Sutton, MA 01590 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Timothy J O'callaghan | 9 Brookside Dr, Sutton, MA 01590 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
| Edward Murphy | 20 Marsh Road, Sutton, MA 01590 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
| Mark Saviet | 409 Central Turnpike, Sutton, MA 01590 | Tax Preparer/facilitator Permit | 2020-02-17 ~ 2022-02-28 |
| Dennis Corsini | 156 Worcester Providence Turnpike, Sutton, MA 01590 | Tax Preparer/facilitator Permit | 2020-02-12 ~ 2022-02-28 |
| Michael S Stone | 5 Rebekah Lane, Sutton, MA 01590 | Veterinarian | 2020-04-01 ~ 2021-03-31 |
| William J Lynch | 63 Fairway View Drive, Sutton, MA 01590 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Andrew W Platt | 28 Carr St, Sutton, MA 01590 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Todd Lornell | 31 Douglas Rd, Sutton, MA 01590 | Real Estate Broker | 2020-01-03 ~ 2021-03-31 |
| Michael S Pashko | 25 Maple Lane, Sutton, MA 01590 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Find all Licenses in zip 01590 | |||
| City | Sutton |
| Zip Code | 01590 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + Sutton |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Beth Degarmo | 328 Russell St Apt 2, Madison, WI 53704-5313 | Physician Assistant | 2019-04-01 ~ 2020-03-31 |
| Julie Brooke Forster | 5 Russell Rd, Cromwell, CT 06416-2470 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Marybeth S Markham | 700 Russell Road, Westfield, MA 01085 | Physician Assistant | 2000-06-06 ~ 2000-08-31 |
| Stephen J Burgess Pa | 218 Russell Street, Hadley, MA 01035 | Physician Assistant | 1998-09-08 ~ 1999-09-30 |
| Russell Raymond Otto | 140 Arbutus Street, Middletown, CT 06457 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Concetta M Russell · Vella | 44 Granite Drive, Penfield, NY 14526 | Physician Assistant | 2006-07-07 ~ 2007-07-31 |
| 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 |
| Russell F Turk Md | Stamford Health Russell Turk, Md, Riverside, CT 06878 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Theresa V Horvath | Physiican Assistant Institute, Bridgeport, CT 06604 | Physician Assistant | 2018-10-01 ~ 2019-09-30 |
Please comment or provide details below to improve the information on RUSSELL LONGENDORFER.
| 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).