BLAISE E SMYTH (Credential# 742481) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is October 1, 2019. The license expiration date date is September 30, 2020. The license status is ACTIVE.
BLAISE E SMYTH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000732. The credential type is physician assistant. The effective date is October 1, 2019. The expiration date is September 30, 2020. The business address is 184 Griswold Drive, West Hartford, CT 06119 1021. The current status is active.
| Licensee Name | BLAISE E SMYTH |
| Credential ID | 742481 |
| Credential Number | 23.000732 |
| Credential Type | Physician Assistant |
| Business Address |
184 Griswold Drive West Hartford CT 06119 1021 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1998-03-06 |
| Effective Date | 2019-10-01 |
| Expiration Date | 2020-09-30 |
| Refresh Date | 2019-07-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 747257 | 26.000338 | Respiratory Care Practitioner | 1995-02-17 | 1998-07-31 - 1999-09-30 | INACTIVE |
| 876547 | 71.910098 | Advanced Emergency Medical Technician | 1991-06-11 | - 1997-09-30 | INACTIVE |
| 857105 | 70.880250 | Emergency Medical Technician | 1988-02-19 | - 1992-03-31 | INACTIVE |
| Street Address | 184 GRISWOLD DRIVE |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06119 1021 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Danna Rae France | 1148 Boulevard, West Hartford, CT 06119 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-10-31 |
| Rayda R Bouma | 122 Richard St, West Hartford, CT 06119 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Norbert M Spencer | 17 Oakwood Ave., West Hartford, CT 06119 | Professional Counselor | 2020-07-01 ~ 2021-06-30 |
| Diedra A Dietter | 9 Birch Road, West Hartford, CT 06119 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Dahlia I Belnavis-bigenho · Belnavis | 186 Whiting Lane, West Hartford, CT 06119 | Respiratory Care Practitioner | 2020-08-01 ~ 2021-07-31 |
| Stephen R Dewey | 68 Richard St, W Hartford, CT 06119 | Architect | 2020-08-01 ~ 2021-07-31 |
| James E Vance Jr | 9 Plymouth Rd, W Hartford, CT 06119 | Architect | 2020-08-01 ~ 2021-07-31 |
| Mark D Hirsch | 105 Griswold Dr, W Hartford, CT 06119 | Architect | 2020-08-01 ~ 2021-07-31 |
| Judith Briggs | 29 Troy St, West Hartford, CT 06119 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Thulan P Vu | 74 Park Road, West Hartford, CT 06119 | Nail Technician | 2020-06-24 ~ 2022-06-30 |
| Find all Licenses in zip 06119 | |||
| City | WEST HARTFORD |
| Zip Code | 06119 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + WEST HARTFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Blaise Smyth | 99 E River Dr Fl 5, East Hartford, CT 06108-7301 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kazmer & Blaise Cellar | 2686 Las Amigas Road, Napa, CA 94559 | Out of State Winery | 2004-05-28 ~ 2005-05-27 |
| Smyth Soft Serv Inc · Smyth's Ice Cream | 75 Hazard Ave, Enfield, CT 06082 | Frozen Dessert Retailer | 2020-01-01 ~ 2020-12-31 |
| Renee Adele Blaise | 81 Allencrest Dr, Stratford, CT 06614-2153 | Physical Therapist Assistant | 2017-06-01 ~ 2018-05-31 |
| Smyth Bus, Inc. | 25 Depot Hill Road, Enfield, CT 06082 | General Intrastate Livery Service | 2019-01-01 ~ 2020-12-31 |
| Smyth, F. Edwin & Son, Inc. | 25 Depot Hill Road, Enfield, CT 06082 | General Intrastate Livery Service | 2019-01-01 ~ 2020-12-31 |
| Stuart D Smyth · Stuart D Smyth Carpentry | 72 Henry Sanford Rd, Bridgewater, CT 06752 | Home Improvement Contractor | 2008-03-31 ~ 2008-11-30 |
| I C Smyth Construction LLC | 157 Elliott Ave, Waterbury, CT 06705-1920 | Home Improvement Contractor | ~ |
| Daniel Smyth | 596 East St S, Suffield, CT 06078-2424 | Milk Sub-dealer | 2012-02-07 ~ 2012-06-30 |
| Kazmer & Blaise Cellar | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2004-05-28 ~ 2007-05-27 |
Please comment or provide details below to improve the information on BLAISE E SMYTH.
| 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).