STEPHANIE E GORT (Credential# 1450581) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is ACTIVE.
STEPHANIE E GORT is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003988. The credential type is physician assistant. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 122 Richmond Lane, West Hartford, CT 06117. The current status is active.
| Licensee Name | STEPHANIE E GORT |
| Credential ID | 1450581 |
| Credential Number | 23.003988 |
| Credential Type | Physician Assistant |
| Business Address |
122 Richmond Lane West Hartford CT 06117 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-10-12 |
| Effective Date | 2020-08-01 |
| Expiration Date | 2021-07-31 |
| Refresh Date | 2020-06-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1513384 | CSP.0068006 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-05-14 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 122 RICHMOND LANE |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06117 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jean M Keefe | 122 Richmond Lane, West Hartford, CT 06117 | Registered Nurse | 2002-07-23 ~ 2003-08-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cathy Tran | 20 Lindy Lane, West Hartford, CT 06117 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Renaissance Craftsmen LLC | 263 Simsbury Road, West Hartford, CT 06117 | Home Improvement Contractor | 2020-06-27 ~ 2020-11-30 |
| Lev Tsarkov | 116 Lyman Road, West Hartford, CT 06117 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Scott Lee Ratchford | 67 Balfour Dr., West Hartford, CT 06117 | Professional Counselor | ~ |
| Gary Neidle | 8 Stratford Rd, West Hartford, CT 06117 | Real Estate Salesperson | 2020-06-26 ~ 2021-05-31 |
| Beverly Vincent | 37 Harwich Lane, West Hartford, CT 06117 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Marc D Palter | 94 Beacon Hill Dr, West Hartford, CT 06117 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| David L Friar | 35 Porter Dr, W Hartford, CT 06117 | Architect | 2020-08-01 ~ 2021-07-31 |
| Adlin C Daye | 147 Mohawk Drive, West Hartford, CT 06117 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Derek M Mcdermott | 61 Ferncliff Drive, West Hartford, CT 06117 | Emergency Medical Technician | ~ |
| Find all Licenses in zip 06117 | |||
| City | WEST HARTFORD |
| Zip Code | 06117 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + WEST HARTFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Stephanie Chawla | 761 Main Ave Ste 201, Norwalk, CT 06851-1080 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Stephanie A Mckinney | 423 E 83rd St Apt 3b, New York, NY 10028-5520 | Physician Assistant | 2011-10-01 ~ 2012-09-30 |
| Stephanie B Fridman Pa-c | 39 Beekman St Fl 4, New York, NY 10038-1521 | Physician Assistant | 2012-08-01 ~ 2013-07-31 |
| Stephanie E Beierle | 12 Dewal Dr, Norwalk, CT 06851-1227 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Stephanie Jamie Pham | 245 5th Ave Floor 3, New York, NY 10016 | Physician Assistant | ~ |
| Stephanie F Behrens | 3 Knollwood Rd, Farmington, CT 06032 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Stephanie Carroll Pa | 166 Linden St Apt #b-6, New Haven, CT 06511 | Physician Assistant | 2007-08-01 ~ 2008-09-30 |
| Stephanie M Lepage Pa | 534 Thrall Ave, Suffield, CT 06078 | Physician Assistant | 2010-08-01 ~ 2011-07-31 |
| Stephanie G Dibble | 271 Bella Vista Dr, Watertown, CT 06795-1360 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Stephanie B. Parrillo | 2560 Dixwell Ave Ste 2b, Hamden, CT 06514-1852 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
Please comment or provide details below to improve the information on STEPHANIE E GORT.
| 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).