GILA C HENESCH
Physician Assistant


Address: 136 Mohawk Drive, West Hartford, CT 06117

GILA C HENESCH (Credential# 742822) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is April 19, 2004. The license expiration date date is June 30, 2005. The license status is INACTIVE.

Business Overview

GILA C HENESCH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001073. The credential type is physician assistant. The effective date is April 19, 2004. The expiration date is June 30, 2005. The business address is 136 Mohawk Drive, West Hartford, CT 06117. The current status is inactive.

Basic Information

Licensee Name GILA C HENESCH
Credential ID 742822
Credential Number 23.001073
Credential Type Physician Assistant
Business Address 136 Mohawk Drive
West Hartford
CT 06117
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2001-04-10
Effective Date 2004-04-19
Expiration Date 2005-06-30
Refresh Date 2009-07-08

Office Location

Street Address 136 Mohawk Drive
City West Hartford
State CT
Zip Code 06117

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City West Hartford
Zip Code 06117
License Type Physician Assistant
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Dataset Information

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).

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