STACEY A ITALIANO
Physical Therapist


Address: 1000 State St Box 3 A, Springfield, MA 01109-3151

STACEY A ITALIANO (Credential# 694041) is licensed (Physical Therapist) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2011. The license expiration date date is May 31, 2012. The license status is INACTIVE.

Business Overview

STACEY A ITALIANO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #14.008466. The credential type is physical therapist. The effective date is June 1, 2011. The expiration date is May 31, 2012. The business address is 1000 State St Box 3 A, Springfield, MA 01109-3151. The current status is inactive.

Basic Information

Licensee Name STACEY A ITALIANO
Credential ID 694041
Credential Number 14.008466
Credential Type Physical Therapist
Business Address 1000 State St Box 3 A
Springfield
MA 01109-3151
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2009-01-21
Effective Date 2011-06-01
Expiration Date 2012-05-31
Refresh Date 2012-09-04

Office Location

Street Address 1000 STATE ST BOX 3 A
City SPRINGFIELD
State MA
Zip Code 01109-3151

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Competitor

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City SPRINGFIELD
Zip Code 01109
License Type Physical Therapist
License Type + County Physical Therapist + SPRINGFIELD

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Dataset Information

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).

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