MARYBETH CARLETTA PA (Credential# 742355) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is May 27, 1997. The license expiration date date is May 31, 1998. The license status is INACTIVE.
MARYBETH CARLETTA PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000606. The credential type is physician assistant. The effective date is May 27, 1997. The expiration date is May 31, 1998. The business address is 24113 Tjown Walk Dr, Hamden, CT 06518. The current status is inactive.
| Licensee Name | MARYBETH CARLETTA PA |
| Credential ID | 742355 |
| Credential Number | 23.000606 |
| Credential Type | Physician Assistant |
| Business Address |
24113 Tjown Walk Dr Hamden CT 06518 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1997-01-03 |
| Effective Date | 1997-05-27 |
| Expiration Date | 1998-05-31 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 45631 | CSP.0025138 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1997-03-01 - 1998-02-28 | INACTIVE |
| Street Address | 24113 TJOWN WALK DR |
| City | HAMDEN |
| State | CT |
| Zip Code | 06518 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Barbara Esposito Aprn | 209 Todd St, Hamden, CT 06518 | Advanced Practice Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Sorrentos Brick Oven Pizzeria | 244 Skiff St, Hamden, CT 06518 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Jenna Bump | 61 Cannon St, Hamden, CT 06518 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jennifer E Pohl | 70 Norwood Avenue, Hamden, CT 06518 | Speech and Language Pathologist | 2020-07-01 ~ 2021-06-30 |
| Nicole O Miller-tyson | 648 Evergreen Ave, Hamden, CT 06518 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Nancy D Anderson | 399 Hillfield Road, Hamden, CT 06518 | Speech and Language Pathologist | 2020-08-01 ~ 2021-07-31 |
| Flowers From The Farm | 1035 Shepard Avenue, Hamden, CT 06518 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Lynda Burke | 68 Linden Avenue, Hamden, CT 06518 | Notary Public Appointment | 2011-12-08 ~ 2016-12-31 |
| Kelly Lynn Huppert | 1334 Town Walk Dr, Hamden, CT 06518 | Master's Level Social Worker | ~ |
| Robert L Engengro | 365 Forest Street, Hamden, CT 06518 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Find all Licenses in zip 06518 | |||
| City | HAMDEN |
| Zip Code | 06518 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + HAMDEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marybeth S Markham | 700 Russell Road, Westfield, MA 01085 | Physician Assistant | 2000-06-06 ~ 2000-08-31 |
| Marybeth A Moore | 60 Ridgewood Rd, West Hartford, CT 06107-2925 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| John R Taylor | 1559 Carletta Drive, Mississauga Ontario, L4X 1E2 | Physician/surgeon | 1993-03-24 ~ 1994-04-30 |
| Marybeth Hafele | 87 Plaskon Dr, Shelton, CT 06484-4325 | Physical Therapist Assistant | 2020-01-01 ~ 2020-12-31 |
| Marybeth M Brown | 8 Perryridge Rd, Greenwich, CT 06830 | Real Estate Salesperson | ~ |
| Carletta Reyes | Meriden, CT 06450 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Physician Assistant Foundation of The American Academy of Physician Assistants | 2318 Mill Rd Ste 1300, Alexandria, VA 22314-6868 | Public Charity | 2019-12-01 ~ 2020-11-30 |
| Carletta Pottinger Thompson | 25 Chatham St, Hartford, CT 06112-1409 | Licensed Practical Nurse | 2020-04-01 ~ 2021-03-31 |
| Carletta C Benjamin | 492-a Westchester Rd, Colchester, CT 06415 | Notary Public Appointment | 1994-03-08 ~ 1999-03-31 |
| Carletta F Fountain | 168 Goodrich Street, Hamden, CT 06517 | Certified Alcohol and Drug Counselor | 2007-03-12 ~ 2008-02-29 |
Please comment or provide details below to improve the information on MARYBETH CARLETTA PA.
| 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).