JOHN J PENDERGAST PA (Credential# 741968) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
JOHN J PENDERGAST PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000219. The credential type is physician assistant. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 246 Federal Road Suite D-12, Brookfield, CT 06804. The current status is active.
| Licensee Name | JOHN J PENDERGAST PA |
| Credential ID | 741968 |
| Credential Number | 23.000219 |
| Credential Type | Physician Assistant |
| Business Address |
246 Federal Road Suite D-12 Brookfield CT 06804 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1993-10-15 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-01-21 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 275556 | CSP.0030706 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2001-03-28 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 752774 | 28.001983 | Radiographer | 1994-11-04 | 2011-03-01 - 2012-02-29 | INACTIVE |
| Street Address | 246 Federal Road Suite D-12 |
| City | Brookfield |
| State | CT |
| Zip Code | 06804 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Juan Liang | 6 Tara Dr, Brookfield, CT 06804 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Lenore A Fox · Castellano | 16 Johns Rd, Brookfield, CT 06804 | Respiratory Care Practitioner | 2020-08-01 ~ 2021-07-31 |
| Xuefang Chen | 13 Hillside Court, Brookfield, CT 06804 | Real Estate Salesperson | ~ |
| J Scott Williams | 30 Obtuse Road South, Brookfield, CT 06804 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Liudmila Yakauleva | 317 Federal Road Suite C, Brookfield, CT 06804 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Brandi L Hennessey | 24 Riverview Court, Brookfield, CT 06804 | Real Estate Salesperson | ~ |
| Medical Warehouse Inc | 72 Grays Bridge Rd, Brookfield, CT 06804 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Heather Lynn Edelmann | 87 Heatherwood Drive, Brookfield, CT 06804 | Notary Public Appointment | 2020-06-25 ~ 2025-06-30 |
| Xiaoming Zheng | 540 Federal Rd, Brookfield, Connecticut 06804, Brookfield, CT 06804 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Shop Rite | Federal Rd, Brookfield, CT 06804 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06804 | |||
| City | Brookfield |
| Zip Code | 06804 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + Brookfield |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| James D Pendergast · Pendergast Construction | 3 Quiet Cove Ln, Griswold, CT 06351 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Andrea Pendergast | 1175 Farmington Ave 4-215, Bristol, CT 06010 | Occupational Therapist Assistant | 2019-08-01 ~ 2021-07-31 |
| Janelle R Pendergast-marr | 7 Wildwood Dr, Columbia, CT 06237-1544 | Occupational Therapist Assistant | 2011-08-01 ~ 2013-07-31 |
| John J Pendergast IIi | 162 Rt 37, New Fairfield, CT 06812 | Emergency Medical Technician | 2013-06-06 ~ 2016-04-01 |
| John B Pendergast | 8 Pepperidge Court, Simsbury, CT 06070 | Real Estate Salesperson | 2019-06-01 ~ 2020-05-31 |
| John V Pendergast Jr | 14 Jeremiah Rd, Sandy Hook, CT 06482-1465 | Heating, Piping & Cooling Limited Contractor | ~ |
| John V Pendergast Jr | 4 Jeremiah Rd, Sandy Hook, CT 06482 | Heating, Piping & Cooling Limited Contractor | ~ |
| John F Pendergast | 43 Totem Trail, Sandy Hook, CT 06482-1138 | Heating, Piping & Cooling Unlimited Journeyperson | 2019-09-01 ~ 2020-08-31 |
| John Leach | Po Box 428, Ivoryton, CT 06442 | Physician Assistant | 2019-10-01 ~ 2020-09-30 |
| John Voytek | 15 East St, Wallingford, CT 06492-4005 | Physician Assistant | ~ |
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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).