MARY S MOON (Credential# 742969) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is April 16, 2007. The license expiration date date is May 31, 2008. The license status is INACTIVE.
MARY S MOON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001220. The credential type is physician assistant. The effective date is April 16, 2007. The expiration date is May 31, 2008. The business address is 303 Sandstone Drive, South Windsor, CT 06074. The current status is inactive.
| Licensee Name | MARY S MOON |
| Credential ID | 742969 |
| Credential Number | 23.001220 |
| Credential Type | Physician Assistant |
| Business Address |
303 Sandstone Drive South Windsor CT 06074 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2002-07-30 |
| Effective Date | 2007-04-16 |
| Expiration Date | 2008-05-31 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 322860 | CSP.0032787 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-03-01 | 2007-03-01 - 2008-02-29 | INACTIVE |
| Street Address | 303 SANDSTONE DRIVE |
| City | SOUTH WINDSOR |
| State | CT |
| Zip Code | 06074 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Daniel R Troiano | 75 Heritage Drive, South Windsor, CT 06074 | Embalmer | 2020-08-01 ~ 2021-07-31 |
| Kyle A Jones | 38 Marilyn Road, South Windsor, CT 06074 | Real Estate Salesperson | ~ |
| Beelzebub Road | 310 Beelzebub Road, South Windsor, CT 06074 | Public Community Living Arrangement | 2018-07-01 ~ 2020-06-30 |
| Barbara Brant Feehan | 139 Rockledge Drive, South Windsor, CT 06074 | Audiologist | 2020-09-01 ~ 2021-08-31 |
| Jillmarie S Macaluso | 230 Orchard Hill Dr, S Windsor, CT 06074 | Respiratory Care Practitioner | 2020-08-01 ~ 2021-07-31 |
| Jason K Smith | 854 Foster Street Ext, South Windsor, CT 06074 | Professional Engineer | 2020-06-26 ~ 2021-01-31 |
| Abc Property Care LLC | 376 Pleasant Valley Road, South Windsor, CT 06074 | Home Improvement Contractor | 2020-06-26 ~ 2020-11-30 |
| Ashley Ann Corridori | 21 Abar Lane, South Windsor, CT 06074 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Rawnak Afrose | 120 Loomis Rd, South Windsor, CT 06074 | Real Estate Salesperson | 2020-06-15 ~ 2021-05-31 |
| Adeola Martins | 467 Oakland Road, South Windsor, CT 06074 | Licensed Practical Nurse | ~ |
| Find all Licenses in zip 06074 | |||
| City | SOUTH WINDSOR |
| Zip Code | 06074 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + SOUTH WINDSOR |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kaitlyn Mary Roseman | 360 3rd St Ste 425, San Francisco, CA 94107-2164 | Physician Assistant | 2020-04-03 ~ 2020-11-30 |
| Mary P Zayas | 9 Pioneer Dr, Copake, NY 12516 | Physician Assistant | 2018-04-01 ~ 2019-03-31 |
| Mary E Fleming | 40 Prospect St. #2-3h, Norwalk, CT 06850 | Physician Assistant | 2004-09-15 ~ 2004-10-31 |
| Mary E Summers | 550 Nut Plains Rd, Guilford, CT 06437 | Physician Assistant | 1999-11-23 ~ 2000-12-31 |
| Mary E Finan Pa | 65 Gilman St, Bridgeport, CT 06605 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Mary M Kelley | 25 Chestnut St, Rockville, CT 06066 | Physician Assistant | 2000-03-15 ~ 2001-05-31 |
| Mary K Ferguson | 96 Straffordshire, Wallingford, CT 06492 | Physician Assistant | 1981-01-01 ~ 1994-06-30 |
| Katherine Mary White | 245 5th Ave Floor 3, New York, NY 10016 | Physician Assistant | ~ |
| Mary Holmes Pa | 188 Woodhaven, Glastonbury, CT 06033 | Physician Assistant | 2002-03-12 ~ 2003-04-30 |
| Mary L Warner | 7 Alden Ave, New Haven, CT 06515-2712 | Physician Assistant | 2013-08-01 ~ 2014-07-31 |
Please comment or provide details below to improve the information on MARY S MOON.
| 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).