DAVID JOSEPH DOMENICO
Physical Therapist Assistant


Address: 134 Caporal St., Cranston, RI 02910

DAVID JOSEPH DOMENICO (Credential# 1595715) is licensed (Physical Therapist Assistant) with Connecticut Department of Consumer Protection. The license effective date is October 23, 2018. The license expiration date date is June 30, 2019. The license status is INACTIVE.

Business Overview

DAVID JOSEPH DOMENICO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #63.001961. The credential type is physical therapist assistant. The effective date is October 23, 2018. The expiration date is June 30, 2019. The business address is 134 Caporal St., Cranston, RI 02910. The current status is inactive.

Basic Information

Licensee Name DAVID JOSEPH DOMENICO
Credential ID 1595715
Credential Number 63.001961
Credential Type Physical Therapist Assistant
Business Address 134 Caporal St.
Cranston
RI 02910
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2018-10-23
Effective Date 2018-10-23
Expiration Date 2019-06-30
Refresh Date 2019-10-03

Office Location

Street Address 134 Caporal St.
City Cranston
State RI
Zip Code 02910

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Mark Saccoccio C/o Saccoccio & Associates Inc, Cranston, RI 02910 Architect 2020-08-01 ~ 2021-07-31
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Mike Xayvongsa 131 Carman St, Cranston, RI 02910 Casino Class I Employee 2019-12-11 ~ 2020-10-31
Pedro J Pena 80 Norfolk St, Cranston, RI 02910 Casino Class I Employee 2019-12-11 ~ 2020-10-31
Edward C Flori 95 Legion Way, Cranston, RI 02910 Casino Class I Employee 2019-12-11 ~ 2020-10-31
Cuimei Zhou 13 Dale Avenue, Cranston, RI 02910 Casino Class I Employee 2019-12-03 ~ 2020-10-31
David D Domenico 134 Caporal St, Cranston, RI 02910 Casino Class I Employee 2019-12-11 ~ 2020-10-31
Aphayrack Ounkeo 150 Burbank St., Cranston, RI 02910 Casino Class I Employee 2019-12-11 ~ 2020-10-31
Joseph D Hanscom 2 Toby Hanna St, Providence, RI 02910 Casino Class I Employee 2019-12-11 ~ 2020-10-31
Franklyn Jimenez 43 Crawford St., Cranston, RI 02910 Casino Class I Employee 2019-12-11 ~ 2020-10-31
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Competitor

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City Cranston
Zip Code 02910
License Type Physical Therapist Assistant
License Type + County Physical Therapist Assistant + Cranston

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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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