DIANE B KECKLEY PA (Credential# 742816) 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.
DIANE B KECKLEY PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001067. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 4 Dairy Lane, Cromwell, CT 06416. The current status is active.
Licensee Name | DIANE B KECKLEY PA |
Credential ID | 742816 |
Credential Number | 23.001067 |
Credential Type | Physician Assistant |
Business Address |
4 Dairy Lane Cromwell CT 06416 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2001-03-15 |
Effective Date | 2020-06-01 |
Expiration Date | 2021-05-31 |
Refresh Date | 2020-04-18 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
275413 | CSP.0030745 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2001-04-24 | 2019-03-01 - 2021-02-28 | ACTIVE |
Street Address | 4 DAIRY LANE |
City | CROMWELL |
State | CT |
Zip Code | 06416 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
W Dale Keckley | 4 Dairy Lane, Cromwell, CT 06416 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Marcia B Henehan | 17 Crest Drive, Cromwell, CT 06416 | Physical Therapist | 2020-07-01 ~ 2021-06-30 |
Sarah C Smith | 6 Court Street, Cromwell, CT 06416 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
Joyce Tayeh | 5 Sunridge Lane, Cromwell, CT 06416 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
Todd J Farris | 53 Lincoln Road, Cromwell, CT 06416 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
Tiffany N Winkler | 50 Fawn Run, Cromwell, CT 06416 | Advanced Practice Registered Nurse | 2020-08-01 ~ 2021-07-31 |
Hasim J Shah | 131 Coles Rd, Cromwell, CT 06416 | Pharmacy Technician | 2020-06-23 ~ 2021-03-31 |
Michelle R Berube | 17 Arrowwood Dr, Cromwell, CT 06416 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
Joy Mekrut-suzio | 352 Main Street, Cromwell, CT 06416 | Speech and Language Pathologist | 2020-09-01 ~ 2021-08-31 |
Gina M Branciforte | 24 Bellaire Manor, Cromwell, CT 06416 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Kimberly A Benson | 10 Springdale Road, Cromwell, CT 06416 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
Find all Licenses in zip 06416 |
City | CROMWELL |
Zip Code | 06416 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + CROMWELL |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Diane M Barnes Pa | 31 Seymour St Ste 100, Hartford, CT 06106-5521 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
Diane St. Pierre | 22-7 Hudson St, Bethel, CT 06801-2031 | Physician Assistant | 2020-02-01 ~ 2021-01-31 |
Diane R Levien | 138 Cedar Rd, Wilton, CT 06897-3631 | Physician Assistant | 2019-11-01 ~ 2020-10-31 |
Diane M Brown Pa | 3259 Hone Ave, Bronx, NY 10469 | Physician Assistant | 2006-08-31 ~ 2007-08-31 |
Hilary Diane Sugar | 103 Fairview Avenue, Boonton, NJ 07005 | Physician Assistant | ~ |
Diane C Erianne Pa | 10 Kimberly Lane, Watertown, CT 06795 | Physician Assistant | 2012-05-01 ~ 2013-04-30 |
Diane Miller | 217 Kelzie Peeler Rd., Murray, KY 42071 | Physician Assistant | 2010-11-01 ~ 2011-10-31 |
Diane R Johnson Pa | 5841 Route 112, Halifax, VT 05358 | Physician Assistant | 2008-11-17 ~ 2009-11-30 |
W Dale Keckley | 4 Dairy Lane, Cromwell, CT 06416 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
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 |
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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).