KELLY LYNAE RICHARDSON
Physician Assistant


Address: 2124 Buhl Ave, North St Paul, MN 55109

KELLY LYNAE RICHARDSON (Credential# 1451949) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is September 28, 2017. The license expiration date date is August 31, 2018. The license status is INACTIVE.

Business Overview

KELLY LYNAE RICHARDSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003971. The credential type is physician assistant. The effective date is September 28, 2017. The expiration date is August 31, 2018. The business address is 2124 Buhl Ave, North St Paul, MN 55109. The current status is inactive.

Basic Information

Licensee Name KELLY LYNAE RICHARDSON
Credential ID 1451949
Credential Number 23.003971
Credential Type Physician Assistant
Business Address 2124 Buhl Ave
North St Paul
MN 55109
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2017-09-28
Effective Date 2017-09-28
Expiration Date 2018-08-31
Refresh Date 2018-12-04

Office Location

Street Address 2124 Buhl Ave
City North St Paul
State MN
Zip Code 55109

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Patrick G Blees 2887 Lake Blvd N, St Paul, MN 55109 Architect 2020-08-01 ~ 2021-07-31
John C Kliethermes Jr 2720 Maplewood Drive, Maplewood, MN 55109 Professional Engineer 2009-07-18 ~ 2010-01-31
Adijat O Lawal 1184 Frisbie Ave., Maplewood, MN 55109 Licensed Practical Nurse 2009-09-17 ~ 2010-10-31
Robert J Salava 2626 No 7th St, N St Paul, MN 55109 Electrical Unlimited Journeyperson ~
Second Harvest Heartland 1140 Gervais Ave, Saint Paul, MN 55109-2020 Public Charity 2020-09-01 ~ 2021-08-31

Competitor

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City North St Paul
Zip Code 55109
License Type Physician Assistant
License Type + County Physician Assistant + North St Paul

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Dataset Information

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).

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