AUDREY DOUGLAS (Credential# 742476) 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.
AUDREY DOUGLAS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000727. The credential type is physician assistant. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 26 John St, Derby, CT 06418. The current status is active.
| Licensee Name | AUDREY DOUGLAS |
| Credential ID | 742476 |
| Credential Number | 23.000727 |
| Credential Type | Physician Assistant |
| Business Address |
26 John St Derby CT 06418 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1998-02-27 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-02-19 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 232642 | CSP.0029360 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2000-03-22 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 26 JOHN ST |
| City | DERBY |
| State | CT |
| Zip Code | 06418 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| George A Kral Jr · Integkral Design & Constr | 26 John St, Derby, CT 06418-2602 | Home Improvement Contractor | 1995-12-01 ~ 1996-11-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Debra A Montini | 8 Academy Hill Ext, Derby, CT 06418 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Laura M Boanno | 131 Marshall La, Derby, CT 06418 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Danyun Chen | 49 Pershing Dr., Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Fan Geng | Shoprite Shopping Center, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Danni Xu | Shoprite Shopping Center49 Pershing Dr, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Yao Zhang | Shoprite Shopping Center 49 Pershing Dr, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Phillip N Burke | 3 Camptown St, Derby, CT 06418 | Emergency Medical Technician | 2017-06-07 ~ 2020-06-30 |
| Diane A Rosner | 229 Shagbark Drive, Derby, CT 06418 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Pamela C Lavelle | 194 Minerva St, Derby, CT 06418 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Grade A Market - Derby LLC | 49 Pershing Dr, Derby, CT 06418 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06418 | |||
| City | DERBY |
| Zip Code | 06418 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + DERBY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Douglas Hickok | Po Box 313, Bethel, PA 19507-0313 | Physician Assistant | 2019-02-01 ~ 2020-01-31 |
| Douglas L Kugel Pa-c | 10 Merrick Ct, Brewster, NY 10509 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Lauren Sloss | 12 Douglas Dr, Cumberland, RI 02864-1519 | Physician Assistant | 2018-07-02 ~ 2019-06-30 |
| Laurel J Harlamoff | 30 Douglas Ave. #a, Stamford, CT 06906 | Physician Assistant | 2003-05-01 ~ 2004-05-31 |
| Sam Taylor Pa | 95169 Douglas Rd, Fernandina Beach, FL 32034-1268 | Physician Assistant | 2014-08-01 ~ 2015-07-31 |
| Douglas R Hood Pa | 169 Ridgewood Ave, North Haven, CT 06473 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Douglas R Paragone | 18 Bretton Rd, West Hartford, CT 06119 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Douglas E Muller | 61-72 77th Street, Middle Village, NY 11379 | Physician Assistant | 2000-03-27 ~ 2001-02-28 |
| Juliane Laine Douglas | Naval Health Clinic Hawaii, Jbphh, HI 96860 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Audrey Moncevicius | 77 Douglas Street, Hartford, CT 06100 | Notary Public Appointment | 1976-07-19 ~ 1981-03-31 |
Please comment or provide details below to improve the information on AUDREY DOUGLAS.
| 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).