MARISSA VAN HENNIK PA (Credential# 333738) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
MARISSA VAN HENNIK PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0033182. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 287 S Main St, Wallingford, CT 06492-4602. The current status is active.
| Licensee Name | MARISSA VAN HENNIK PA |
| Credential ID | 333738 |
| Credential Number | CSP.0033182 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
287 S Main St Wallingford CT 06492-4602 |
| Business Type | BUSINESS |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2003-02-13 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 743073 | 23.001324 | Physician Assistant | 2003-01-22 | 2019-12-01 - 2020-11-30 | ACTIVE |
| Street Address | 287 S MAIN ST |
| City | WALLINGFORD |
| State | CT |
| Zip Code | 06492-4602 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Amanda F Votto Pa-c | 283 S Main St, Wallingford, CT 06492-4602 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Gaetanos Home Improvement | 271 S Main St, Wallingford, CT 06492-4602 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Michael Urban | 231 S Main St, Wallingford, CT 06492-4602 | Occupational Therapist | 2019-08-01 ~ 2021-07-31 |
| Brie E Lowenstein | 243 S Main St, Wallingford, CT 06492-4602 | Master's Level Social Worker | 2019-12-01 ~ 2020-11-30 |
| Kevin Gaetano | 271 S Main St, Wallingford, CT 06492-4602 | Wholesaler Salesman | 2017-02-01 ~ 2019-01-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrea Zola | 53 Alison Ave., Wallingford, CT 06492 | Esthetician | ~ |
| Kyungok Choi | 90 Ward St, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Giang Nguyen | 45 Country Club Lane, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-11-30 |
| Lc Artistry | 207 North Colony Road, Wallingford, CT 06492 | Esthetician | ~ |
| Katie Lee | 20 Angela Dr, Wallingford, CT 06492 | Paramedic | 2020-09-01 ~ 2021-08-31 |
| Vinny's Deli | 567 Center St, Wallingford, CT 06492 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Michele Ruggiero | 26 Leigus Road, Wallingford, CT 06492 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Dianna K Ball | 104 Simpson Ave, Wallingford, CT 06492 | Speech and Language Pathologist | 2020-08-01 ~ 2021-07-31 |
| Ann Marie Richardson | 20 Mohawk Drive, Wallingford, CT 06492 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Joann Hummel | 60 Deer Run Road, Wallingford, CT 06492 | Medication Administration Certification | 2018-08-21 ~ 2020-08-20 |
| Find all Licenses in zip 06492 | |||
| City | WALLINGFORD |
| Zip Code | 06492 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WALLINGFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marissa L Lahaie | 46 Hobbs Rd, Lee, NH 03861 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa D Foster | 835 Mix Ave #411, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Marissa L Stankus | 244 Parklawn Dr, Waterbury, CT 06708-2349 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa Tennant | 365 Montauk Ave, New London, CT 06320 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa C Bayerl | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa M Lavin | 38 Elder St, Milford, CT 06460-6464 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa De Freese | 29 Hospital Plaza, Stamford, CT 06902 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Marissa A Schwartz | 44 Oakwood Ave, West Hartford, CT 06119-2175 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa M Smith | 443 Wendell Terrace, Syracuse, NY 13203 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa A Novack | 120 Morgan St Apt 401b, Stamford, CT 06905-5438 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).