PHYLLIS R JORDAN (Credential# 666455) is licensed (Licensed Practical Nurse) with Connecticut Department of Consumer Protection. The license effective date is January 14, 1998. The license expiration date date is February 28, 1999. The license status is INACTIVE.
PHYLLIS R JORDAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #11.022192. The credential type is licensed practical nurse. The effective date is January 14, 1998. The expiration date is February 28, 1999. The business address is 1841 Davis Ave, Kingman, AZ 86401. The current status is inactive.
| Licensee Name | PHYLLIS R JORDAN |
| Credential ID | 666455 |
| Credential Number | 11.022192 |
| Credential Type | Licensed Practical Nurse |
| Business Address |
1841 Davis Ave Kingman AZ 86401 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1987-06-01 |
| Effective Date | 1998-01-14 |
| Expiration Date | 1999-02-28 |
| Refresh Date | 2009-07-08 |
| Street Address | 1841 DAVIS AVE |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86401 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Geoffrey Lane Schroder | 1732 Motor Ave, Kingman, AZ 86401 | Registered Nurse | 2019-10-01 ~ 2020-09-30 |
| New Life Clinics | 5536 N. Copper Canyon Wy, Kingman, AZ 86401 | Public Charity | 2007-06-01 ~ 2008-05-31 |
| Cristita E Nagsuban · Strera | 3350 Harrison Street, Kingman, AZ 86401 | Registered Nurse | 1996-09-26 ~ 1997-10-31 |
| Tasha R Inturrisi · Gibson | 2365 Northfield Avenue, Kingman, AZ 86401 | Licensed Practical Nurse | 2005-09-02 ~ 2006-08-31 |
| Michael J Stagner | 390 Greenway Dr, Kingman, AZ 86401-3965 | Physician/surgeon | 2011-05-20 ~ 2012-03-31 |
| Vincent N Miles Md | 7849 S Hawk Rd, Kingman, AZ 86401-4774 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Carol E Tarquinio | 600 Rawhide Dr, Kingman, AZ 86401-7285 | Physical Therapist | 2013-03-12 ~ 2014-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Stephanie Smith | 3880 Stockton Hill Rd Ste 103-175, Kingman, AZ 86409 | Registered Nurse | 2019-03-19 ~ 2019-09-30 |
| Michael T Moore | Po Box 6056, Kingman, AZ 86402-6056 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Lisa Anne Spann | 1041 Astor Ave Apt 1, Kingman, AZ 86409-3903 | Registered Nurse | 2011-02-01 ~ 2012-01-31 |
| Linda J Butler | 3880 Stockton Hill Rd # 103-159, Kingman, AZ 86409-0595 | Registered Nurse | ~ |
| Jeanette R Eakerns | 960 Palo Verde Drive, Kingman, AZ 86104 | Registered Nurse | 2006-04-03 ~ 2007-03-31 |
| Donald G. Leschnik | P.o. Box #6742, Kingman, AZ 86402 | Pharmacist | 1999-02-01 ~ 2000-01-31 |
| Luisa O'connor | Po Box 6056, Kingman, AZ 86402-6056 | Pharmacy Technician | 2020-04-01 ~ 2021-03-31 |
| City | KINGMAN |
| Zip Code | 86401 |
| License Type | Licensed Practical Nurse |
| License Type + County | Licensed Practical Nurse + KINGMAN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Don E Henson | 1196 W South Jordan Parkway, South Jordan, UT 84095 | Licensed Practical Nurse | 2003-12-23 ~ 2004-10-31 |
| Phyllis A Green | Rr-1 Box 677, Putney, VT 05346 | Licensed Practical Nurse | 1995-02-27 ~ 1996-02-29 |
| Phyllis C Riddick | 984 Willard Ave, Newington, CT 06111 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Phyllis C Trexler | 197 Alexander Rd, New Britain, CT 06053 | Licensed Practical Nurse | 2020-04-01 ~ 2021-03-31 |
| Phyllis J Andersen | 990 W Main St Apt 315, Waterbury, CT 06708-2625 | Licensed Practical Nurse | 2019-04-01 ~ 2020-03-31 |
| Phyllis R Drost | Po Box 7255, Prospect, CT 06712-0255 | Licensed Practical Nurse | 2018-09-01 ~ 2019-08-31 |
| Phyllis M Clark | 135 Anthony Dr, Bristol, CT 06010 | Licensed Practical Nurse | 1994-02-15 ~ 1994-11-30 |
| Phyllis A Rogovsky | 155 Smith St Apt 2f, Derby, CT 06418-1244 | Licensed Practical Nurse | 2016-07-01 ~ 2017-06-30 |
| Phyllis M Brown | 40 Gilbert Ave, Bloomfield, CT 06002 | Licensed Practical Nurse | 1998-08-07 ~ 1999-05-31 |
| Phyllis F Rish | 198 Newton Rd, Woodbridge, CT 06525 | Licensed Practical Nurse | 2020-05-01 ~ 2021-04-30 |
Please comment or provide details below to improve the information on PHYLLIS R JORDAN.
| 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).