AMANDA MALLICO PA (Credential# 326062) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2003. The license expiration date date is February 28, 2004. The license status is INACTIVE.
AMANDA MALLICO PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0033038. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2003. The expiration date is February 28, 2004. The business address is 15 Maple Ln, Avon, CT 06001. The current status is inactive.
| Licensee Name | AMANDA MALLICO PA |
| Credential ID | 326062 |
| Credential Number | CSP.0033038 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
15 Maple Ln Avon CT 06001 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 2003-03-01 |
| Expiration Date | 2004-02-28 |
| Refresh Date | 2009-01-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 743042 | 23.001293 | Physician Assistant | 2002-11-18 | 2002-11-18 - 2003-05-31 | INACTIVE |
| Street Address | 15 MAPLE LN |
| City | AVON |
| State | CT |
| Zip Code | 06001 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Liana N Pagano | 15 Maple Ln, Avon, CT 06001-4523 | Physical Therapist | 2020-05-01 ~ 2021-04-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Julie R Deitch | 5 Bridle Path, Avon, CT 06001 | Dental Hygienist | 2020-07-01 ~ 2021-06-30 |
| Brigitte Nicole Heleniak | 16 Sunset Trail, Avon, CT 06001 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Coffee Trade Inc (the) | 21 West Main St, Avon, CT 06001 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Elizabeth Stockwell | 44 Applewood Lane, Avon, CT 06001 | Real Estate Salesperson | ~ |
| Mollie Velma Lahaie | 14 Red Mountain Lane, Avon, CT 06001 | Registered Nurse | 2020-06-26 ~ 2020-08-31 |
| Meiling Chen | Avon Nail 315 W Main Street, Avon, CT 06001 | Nail Technician | ~ |
| Richard J Kaiser | 72 Westland Road, Avon, CT 06001 | Architect | 2020-08-01 ~ 2021-07-31 |
| Michele L Sweitzer | 12 Bluestone Lane, Avon, CT 06001 | Real Estate Salesperson | 2020-06-25 ~ 2021-05-31 |
| Caroline O Amin | 5 Colby Way, Avon, CT 06001 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Christine Burns | 102 New Road, Avon, CT 06001 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06001 | |||
| City | AVON |
| Zip Code | 06001 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + AVON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Amanda H Uva | 6 Chiltern St, Farmington, CT 06032-1533 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda N Rea | 195 Broadmere Rd, Stratford, CT 06614 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda Lu | 71 Haynes St, Manchester, CT 06040-4131 | Controlled Substance Registration for Practitioner | 2019-05-29 ~ 2021-02-28 |
| Amanda N Pucci | 22 Lenox Ave, Stamford, CT 06906-2315 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda Shreders | 772 Westover Rd, Stamford, CT 06902-1329 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Amanda A Panissidi | 54 Chestnut St, Middletown, CT 06457-3803 | Controlled Substance Registration for Practitioner | 2015-08-04 ~ 2017-02-28 |
| Michelle N Brenes Pa | 41 Amanda Cir, Windsor, CT 06095-3466 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda J Ponte | 11 South Rd Ste 250, Farmington, CT 06032-2484 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda E Decew | 374 Grand Ave, New Haven, CT 06513 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda J Morvai | 39 Stonybrook Rd Ste 2, Stratford, CT 06614-3752 | Controlled Substance Registration for Practitioner | 2019-08-19 ~ 2021-02-28 |
Please comment or provide details below to improve the information on AMANDA MALLICO PA.
| 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).