MARILYN E OLSEN PA-C (Credential# 742546) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is ACTIVE.
MARILYN E OLSEN PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000797. The credential type is physician assistant. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 850 Straits Tpke, Middlebury, CT 06762. The current status is active.
| Licensee Name | MARILYN E OLSEN PA-C |
| Credential ID | 742546 |
| Credential Number | 23.000797 |
| Credential Type | Physician Assistant |
| Business Address |
850 Straits Tpke Middlebury CT 06762 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1998-12-18 |
| Effective Date | 2020-08-01 |
| Expiration Date | 2021-07-31 |
| Refresh Date | 2020-05-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 129292 | CSP.0027516 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 866430 | 70.940650 | Emergency Medical Technician | 1993-12-01 | - 1996-03-31 | INACTIVE |
| Street Address | 850 STRAITS TPKE |
| City | MIDDLEBURY |
| State | CT |
| Zip Code | 06762 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sina Raissi Md | 850 Straits Tpke, Middlebury, CT 06762-2843 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Sirisha Guthikonda | 850 Straits Tpke, Middlebury, CT 06762-2843 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patricia E Rosa · Lambo | 76 East Farm Rd, Middlebury, CT 06762 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Kathy Ann Calo · Bellino | 116 Carriage Drive, Middlebury, CT 06762 | Hairdresser/cosmetician | 2020-06-01 ~ 2022-05-31 |
| Laurie V Massetti | 60 Yale Avenue, Middlebury, CT 06762 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Timex Corp | Park Rd Ext, Middlebury, CT 06762 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Margaret E Mowrey | 57 Marney Drive, Middlebury, CT 06762 | Licensed Clinical Social Worker | 2020-08-01 ~ 2021-07-31 |
| Giuseppe Tripodi | 687 Straits Tpk, Middlebury, CT 06762 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Elise L Callahan | 77 Christian Rd, Middlebury, CT 06762 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Michelle King | 91 Kissewaug Rd, Middlebury, CT 06762 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Michael F Simms IIi | 80 Burr Hall Road, Middlebury, CT 06762 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kelly M Barbaris | 62 Yale Avenue, Middlebury, CT 06762 | Physical Therapist | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06762 | |||
| City | MIDDLEBURY |
| Zip Code | 06762 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + MIDDLEBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Adam R Olsen Pa | 13 Holmes Rd, Ridgefield, CT 06877-4301 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Alyssa Olsen | 19 Moose Hill Road, Trumbull, CT 06611 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Fred J Olsen · E & O Inc Dba Erhard & Olsen Inc | 31 Henry St, Greenwich, CT 06830 | Home Improvement Contractor | 1995-06-23 ~ 1995-11-30 |
| Olsen Builders Inc | 51 Elderslie Lane, Woodbridge, CT 06525 | New Home Construction Contractor | 2005-11-17 ~ 2007-09-30 |
| Erhard & Olsen Inc | 31 Henry St, Greenwich, CT 06830 | Home Improvement Contractor | ~ 1995-08-01 |
| Richard D. Olsen · Olsen and Sons Gen Carpentry | 162 Gardner Ave, New London, CT 06320 | Home Improvement Contractor | ~ 1995-12-01 |
| Leanne T Olsen | 2 Estey Way, Canton, MA 02021 | Physical Therapist Assistant | 2003-12-15 ~ 2006-11-01 |
| Kirsten M Olsen | 169 Center Street, Manchester, CT 06040 | Occupational Therapist Assistant | 1999-08-17 ~ 2001-07-31 |
| Ruth M Olsen | 35 Bunker Hill Rd., Watertown, CT 06795 | Physical Therapist Assistant | ~ 2006-11-01 |
| Martin Olsen Jr · Tobias Olsen, Contractor | 802 Ocean Ave Rear, New London, CT 06320 | Home Improvement Contractor | 1998-12-01 ~ 1999-11-30 |
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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).