CHRISTOPHER FAVULLI (Credential# 1662862) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
CHRISTOPHER FAVULLI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.004558. The credential type is physician assistant. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 585 Arrowhead Dr, Orange, CT 06477-2306. The current status is active.
Licensee Name | CHRISTOPHER FAVULLI |
Credential ID | 1662862 |
Credential Number | 23.004558 |
Credential Type | Physician Assistant |
Business Address |
585 Arrowhead Dr Orange CT 06477-2306 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2019-08-07 |
Effective Date | 2020-04-01 |
Expiration Date | 2021-03-31 |
Refresh Date | 2020-03-18 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1679693 | CSP.0072089 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-08-07 | 2019-08-07 - 2021-02-28 | ACTIVE |
Street Address | 585 ARROWHEAD DR |
City | ORANGE |
State | CT |
Zip Code | 06477-2306 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Jennifer M Bosma | 585 Arrowhead Dr, Orange, CT 06477-2306 | Speech and Language Pathologist | 2019-08-01 ~ 2020-07-31 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Jaya A Gobin Md | 627 Arrowhead Dr, Orange, CT 06477-2306 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
Laura A Briggs | 282 Hawthorne Lane, Orange, CT 06477-2306 | Dental Hygienist | 2020-03-01 ~ 2021-02-28 |
Christina M Klanchich | 577 Arrowhead Dr, Orange, CT 06477-2306 | Hairdresser/cosmetician | 2018-10-01 ~ 2020-09-30 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Rakesh H Patel Md | 596 Cedar Grove, Orange, CT 06477 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
John D Mainwaring Dds | 240 Indian River Rd, Suite A7, Orange, CT 06477 | Dentist | 2020-08-01 ~ 2021-07-31 |
Hea Sun Kwak | 477 Howellton Rd, Orange, CT 06477 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2021-08-31 |
Munsons Candy Kitchen Inc | 109 Boston Post Rd, Orange, CT 06477 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Takashi Yoshikawa | 151 Old Tavern Road, Orange, CT 06477 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
Yam Wong | 21 Country Club Close, Orange, CT 06477 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
Shitong Liu | 519 Boston Post Rd Orange, Orange, CT 06477 | Nail Technician | ~ |
Robert A Lamparski | Po B0x# 1183, Orange, CT 06477 | Real Estate Salesperson | 2019-06-01 ~ 2020-05-31 |
Rolando R Lopez | 22 Tyler City Rd, Orange, CT 06477 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
Lisa Courtney | 470 Locust Drive, Orange, CT 06477 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
Find all Licenses in zip 06477 |
City | ORANGE |
Zip Code | 06477 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + ORANGE |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Christopher J Edelstein | 4 Cornell Rd, Shoreham, NY 11786 | Physician Assistant | ~ |
Christopher Ortiz | 339 Massachusetts Ave, Arlington, MA 02474 | Physician Assistant | ~ |
Christopher Prezzano | 94 Cayuga Rd, Putnam Valley, NY 10579-2106 | Physician Assistant | ~ |
Christopher J Dillon | 159 Oakridge Dr, Unionville, CT 06085-1476 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
Michelle Ana Figueroa | 26 Christopher Ter, West Springfield, MA 01089-4523 | Physician Assistant | ~ |
Christopher Mercier | Po Box 7283, Kensington, CT 06037-7283 | Physician Assistant | 2014-11-01 ~ 2015-10-31 |
Christopher D Sands | 771 Post Rd, Wakefield, RI 02879 | Physician Assistant | 2019-11-15 ~ 2020-09-30 |
Christopher J Kopin Pa-c | 31 Jarvis Rd, Old Saybrook, CT 06475-2909 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
Christopher Bordelon | 15502 Granby Pl, Tampa, FL 33624-1572 | Physician Assistant | ~ |
Christopher M Bonci | 6 Fordham Ave., Feeding Hills, MA 01030 | Physician Assistant | ~ |
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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).