STACY HOLTZ PA (Credential# 742465) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
STACY HOLTZ PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000716. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 245 Jeremy Swamp Road, Southbury, CT 06488. The current status is active.
Licensee Name | STACY HOLTZ PA |
Credential ID | 742465 |
Credential Number | 23.000716 |
Credential Type | Physician Assistant |
Business Address |
245 Jeremy Swamp Road Southbury CT 06488 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 1998-01-30 |
Effective Date | 2020-06-01 |
Expiration Date | 2021-05-31 |
Refresh Date | 2020-05-18 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
196157 | CSP.0026670 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
867237 | 70.941459 | Emergency Medical Technician | 1994-09-01 | - 1996-09-30 | INACTIVE |
Street Address | 245 JEREMY SWAMP ROAD |
City | SOUTHBURY |
State | CT |
Zip Code | 06488 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Jillian Jung | 582 Patriot Rd, Southbury, CT 06488 | Radiographer | 2020-08-01 ~ 2021-07-31 |
Mary E Kohler | 201 Old Highway, Southbury, CT 06488 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Theresa K Bobak | 266b Heritage Village, Southbury, CT 06488 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
Kelly Watson | 800 Main Street South Suite 102, Southbury, CT 06488 | Medication Administration Certification | 2018-06-27 ~ 2020-06-26 |
Mcdonald's Rest #2104 | 44 Division St, Derby, CT 06488 | Bakery | 2020-07-01 ~ 2021-06-30 |
Shirley A Frager | 5 West View Rd, Southbury, CT 06488 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Maureen K Boyd | 77 Shane Drive, Southbury, CT 06488 | Physical Therapist | 2020-09-01 ~ 2021-08-31 |
South Britain Oil LLC | 424 Old Field Rd, Southbury, CT 06488 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Won Ju Lee | 995 Old Field Rd, Southbury, CT 06488 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-01-31 |
Mcdonald's Rest #27001 | 652 New Haven Ave, Derby, CT 06488 | Bakery | 2020-07-01 ~ 2021-06-30 |
Find all Licenses in zip 06488 |
City | SOUTHBURY |
Zip Code | 06488 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + SOUTHBURY |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Stacy S Adil | 84 Hawthorne Ave, Hamden, CT 06517-1825 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
Stacy Anne Henderson Pa | 41 Germantown Rd Ste 101, Danbury, CT 06810-4087 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
Stacy Fuller Baecker Pa-c | 28 Magnolia Ave, Norwalk, CT 06850-3631 | Physician Assistant | 2010-09-01 ~ 2011-08-31 |
Stacy E Shimp | 1673 Ludwell Drive, Ambler, PA 19002 | Physician Assistant | 2019-12-01 ~ 2020-11-30 |
Holtz Excavation LLC | 45 Ward St, Wallingford, CT 06492-4022 | Home Improvement Contractor | 2013-04-17 ~ 2013-11-30 |
Stacy Alex Robinson | 8246 Azur Coast Boulevard, Lake Worth, FL 33467 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
Holtz Rubenstein Reminick LLP | 125 Baylis Road, Melville, NY 11747 | Certified Public Accountant Firm Permit | 2009-01-01 ~ 2009-12-31 |
Stacy A Borucki | 4 Dover Rd., So. Hadley, MA 01075 | Physical Therapist Assistant | ~ 2006-11-01 |
Stacy L James | 84 Roosevelt Ave. Ext., Preston, CT 06365 | Physical Therapist Assistant | 2019-10-01 ~ 2020-09-30 |
Stacy Marie Rivers | 100 Ben St, Bristol, CT 06010-3228 | Physical Therapist Assistant | 2020-07-01 ~ 2021-06-30 |
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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).