JACKIE L BOULWARE (Credential# 1523001) is licensed (Physical Therapist Assistant) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2019. The license expiration date date is November 30, 2020. The license status is ACTIVE.
JACKIE L BOULWARE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #63.001962. The credential type is physical therapist assistant. The effective date is December 1, 2019. The expiration date is November 30, 2020. The business address is 46 Chalmers Avenue, Bridgeport, CT 06604. The current status is active.
| Licensee Name | JACKIE L BOULWARE |
| Credential ID | 1523001 |
| Credential Number | 63.001962 |
| Credential Type | Physical Therapist Assistant |
| Business Address |
46 Chalmers Avenue Bridgeport CT 06604 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-11-01 |
| Effective Date | 2019-12-01 |
| Expiration Date | 2020-11-30 |
| Refresh Date | 2020-03-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 740013 | 20.056453 | Hairdresser/Cosmetician | 2007-12-12 | 2018-12-01 - 2020-11-30 | ACTIVE |
| Street Address | 46 Chalmers Avenue |
| City | Bridgeport |
| State | CT |
| Zip Code | 06604 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Famous Pizza | 430 Park Avenue, Bridgeport, CT 06604 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Yishuang Chen | 15 Cottege Pl, Bridgeport, CT 06604 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Yazhen Yang | 670 W Taft Ave, Bridgeport, CT 06604 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Mai Hoang Diep | 1450 North Ave., Bridgeport, CT 06604 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Kayleen Barrios | 324 Benham Avenue, Bridgeport, CT 06604 | Hairdresser/cosmetician | ~ |
| Mbrk Construction LLC | 2450 North Ave, Bridgeport, CT 06604 | Home Improvement Contractor | 2020-06-18 ~ 2020-11-30 |
| Leovigilda Navarro-vasquez | 168 Pacific St, Bridgeport, CT 06604 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Katherine H Szilagyi-fletcher · Szilagyi | 615 West Taft Ave, Bridgeport, CT 06604 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Shakeema Demetria Barnes | 508 Harral Ave Apt #129, Bridgeport, CT 06604 | Licensed Practical Nurse | 2020-06-22 ~ 2021-03-31 |
| Margaret I Dennehy | 51 Bancroft Ave, Bridgeport, CT 06604 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Find all Licenses in zip 06604 | |||
| City | Bridgeport |
| Zip Code | 06604 |
| License Type | Physical Therapist Assistant |
| License Type + County | Physical Therapist Assistant + Bridgeport |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jackie M Schuh | 33 Talcott Ave, Warwick, RI 02889-3634 | Occupational Therapist Assistant | ~ 1997-07-31 |
| Jackie F Balzer | 36 Woodside Dr, Wethersfield, CT 06109-1463 | Physical Therapist | 2020-01-01 ~ 2020-12-31 |
| Jackie K Shute | 43 Westland Av, West Hartford, CT 06107 | Physical Therapist | 2008-10-17 ~ 2009-12-31 |
| One A Any | 123, Avon, CT 06001 | Physical Therapist Assistant | 2001-01-31 ~ 2002-01-01 |
| Antony Pinto | Bronx, NY 10461 | Physical Therapist Assistant | ~ |
| Dollyann Echevarria | Carolina, PR 00983 | Physical Therapist Assistant | ~ |
| Luz H Rivera | 534 High St, Fairfield, CT 06824-4662 | Physical Therapist Assistant | 2019-01-01 ~ 2019-12-31 |
| Heisha L Pagan | 370 Sherman Ave, New Haven, CT 06511-3109 | Physical Therapist Assistant | ~ |
| Diane M.t. Cano | 10 Old Well Ct, Norwalk, CT 06855-2014 | Physical Therapist Assistant | 2019-11-01 ~ 2020-10-31 |
| Maxwell King | 48 Moorland Ave, Cranston, RI 02905-3513 | Physical Therapist Assistant | ~ |
Please comment or provide details below to improve the information on JACKIE L BOULWARE.
| 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).