MICHAEL R ELLWOOD (Credential# 742296) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2014. The license expiration date date is April 30, 2015. The license status is INACTIVE.
MICHAEL R ELLWOOD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000547. The credential type is physician assistant. The effective date is May 1, 2014. The expiration date is April 30, 2015. The business address is 12784 Fox Keep Run, Fairfax, VA 22033-2233. The current status is inactive.
| Licensee Name | MICHAEL R ELLWOOD |
| Credential ID | 742296 |
| Credential Number | 23.000547 |
| Credential Type | Physician Assistant |
| Business Address |
12784 Fox Keep Run Fairfax VA 22033-2233 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL; PRIOR DISCIPLINE |
| Issue Date | 1996-01-12 |
| Effective Date | 2014-05-01 |
| Expiration Date | 2015-04-30 |
| Refresh Date | 2015-08-10 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 180643 | CSP.0025310 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2004-02-29 - 2005-02-28 | INACTIVE |
| Street Address | 12784 FOX KEEP RUN |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033-2233 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ayman I Elbarasi | 3600 Plum Dale Dr, Fairfax, VA 22033 | Professional Engineer | 2020-06-16 ~ 2021-01-31 |
| Rajan Adhikari | 13353 Foxhole Dr, Fairfax, VA 22033 | Tax Preparer/facilitator Permit | 2020-02-11 ~ 2022-02-28 |
| Claire E Dusek | 12105 Greenwood Ct, #202, Fairfax, VA 22033 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Adrienne Drexler | 13291 Blueberry Lane, #202a, Fairfax, VA 22033 | Embalmer | 2020-03-01 ~ 2021-02-28 |
| Tuan Duc Hoang | 3975 Fair Ridge Drive, Fairfax, VA 22033 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Gabriel R Velicu | 3619 Highland Pl, Fairfax, VA 22033 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Todd R Rossini | 12500 Thompson Road, Fairfax, VA 22033 | Certified Public Accountant License | 2020-01-01 ~ 2020-12-31 |
| Rajah S Augustinraj | 13307 Poplar Tree Rd, Fairfax, VA 22033 | Professional Engineer | 2018-02-01 ~ 2019-01-31 |
| Adam R Wynn | 4215 Jefferson Oaks Circle, Fairfax, VA 22033 | Landscape Architect | 2019-08-01 ~ 2020-07-31 |
| Susan H Watson | 4116 Plaza Lane, Fairfax, VA 22033 | Registered Nurse | 2019-04-01 ~ 2020-03-31 |
| Find all Licenses in zip 22033 | |||
| City | FAIRFAX |
| Zip Code | 22033 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + FAIRFAX |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael Miller | 200 Ellwood Rd, Kensington, CT 06037 | Home Improvement Contractor | 1999-04-19 ~ 1999-11-30 |
| Michael T Keezing | C/0 190 Ellwood Road, Kensington, CT 06037 | Emergency Medical Technician | ~ 1991-07-01 |
| Michael Moi | 85 Riverside Ave Apt G2, Stamford, CT 06905-4421 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Michael J Nolan Pa | 387 Crestwood Dr, Cheshire, CT 06410 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Michael Suprenant Pa-c | 2 Eastview Dr, Simsbury, CT 06070-3010 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Michael L Zande Pa | 31 Seymour St Ste 100, Hartford, CT 06106-5521 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Michael B Heilbrunn Pa | 80 Phyfe Rd, Fairfield, CT 06824 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Michael J Griffin | 1 Tannery Rd, Fiskdale, MA 01518-1170 | Physician Assistant | 2016-08-01 ~ 2017-07-31 |
| Michael T Oesau Pa | 267 Grant St, Bridgeport, CT 06610 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Michael S Thibault | 15 Essex Dr, Milford, CT 06460-3810 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on MICHAEL R ELLWOOD.
| 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).