NICOLE ANN DIETZEL (Credential# 1679198) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2020. The license expiration date date is August 31, 2021. The license status is ACTIVE.
NICOLE ANN DIETZEL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.004636. The credential type is physician assistant. The effective date is September 1, 2020. The expiration date is August 31, 2021. The business address is 94 Hawthorne Dr, Southington, CT 06489-2818. The current status is active.
Licensee Name | NICOLE ANN DIETZEL |
Credential ID | 1679198 |
Credential Number | 23.004636 |
Credential Type | Physician Assistant |
Business Address |
94 Hawthorne Dr Southington CT 06489-2818 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2019-10-11 |
Effective Date | 2020-09-01 |
Expiration Date | 2021-08-31 |
Refresh Date | 2020-06-13 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1798860 | CSP.0072612 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-10-15 | 2019-10-15 - 2021-02-28 | ACTIVE |
Street Address | 94 HAWTHORNE DR |
City | SOUTHINGTON |
State | CT |
Zip Code | 06489-2818 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Hdl Handyman Service LLC | 46 Hawthorne Dr, Southington, CT 06489-2818 | Home Improvement Contractor | 2012-12-01 ~ 2013-11-30 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Sarah M Moon | 321 Pilgrim Lane, Southington, CT 06489 | Esthetician | ~ |
Joanna Milewski | 23 Stacy Cate Drive, Southington, CT 06489 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Richard M Testa | 81 Winter Park Road, Southington, CT 06489 | Massage Therapist | 2020-08-01 ~ 2022-07-31 |
Valley Roofing LLC | 88 Ladyslipper Lane, Southington, CT 06489 | Home Improvement Contractor | ~ |
Dunkin Donuts · New England Donuts LLC | 856 Queen St, Southington, CT 06489 | Bakery | 2020-07-01 ~ 2021-06-30 |
Elizabeth E Pizzuto | 45 Water Street, Southington, CT 06489 | Real Estate Salesperson | 2020-06-18 ~ 2021-05-31 |
Nicholas C Ingel | 515 West Street, Southington, CT 06489 | Heating, Piping & Cooling Limited Journeyperson | 2020-06-23 ~ 2021-08-31 |
Tyrone J Correa | 84 Minthal Drive, Southington, CT 06489 | Real Estate Salesperson | 2020-06-19 ~ 2021-05-31 |
Marilyn F Coppola | 114 Spring Hill Rd, Southington, CT 06489 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
Christine M Liebler | 30 Sultana Terrace, Southington, CT 06489 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Find all Licenses in zip 06489 |
City | SOUTHINGTON |
Zip Code | 06489 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + SOUTHINGTON |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Courtney Nicole Enos | 916 1/2 4th St Ne, Byron, MN 55920-1530 | Physician Assistant | ~ |
Nicole R Ciccia | 71 Joy Rd Apt C, Milford, CT 06460-6052 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
Nicole S Feagin | 30 Shelburne Rd, Stamford, CT 06902-3628 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
Ashley Nicole Hiep | 3 Sgt. Demeola Rd., Blauvelt, NY 10913 | Physician Assistant | ~ |
Nicole Ferrantelli | 59 Old Post Rd Apt F7, Clinton, CT 06413-1864 | Physician Assistant | 2010-07-01 ~ 2011-06-30 |
Nicole M Esposito | 5 Lexington Ct, Shelton, CT 06484-5961 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
Nicole M Spataro | 427 Williams Rd, Wallingford, CT 06492-2690 | Physician Assistant | 2018-11-01 ~ 2019-10-31 |
Nicole D Greco Pa | 604 Tompkins Ave Apt B5, Mamaroneck, NY 10543-3729 | Physician Assistant | 2015-03-01 ~ 2016-02-29 |
Jaime A Camacho | 6 Nicole Ln, Burlington, CT 06013-2123 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
Nicole M Williams | 13 Garden Terrace, Shelton, CT 06484 | Physician Assistant | 2018-04-01 ~ 2019-03-31 |
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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).