JASON P KOTULA PA
Physician Assistant


Address: 286 Stonewell Dr, Saint Johns, FL 32259-8388

JASON P KOTULA PA (Credential# 743370) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2018. The license expiration date date is July 31, 2019. The license status is INACTIVE.

Business Overview

JASON P KOTULA PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001621. The credential type is physician assistant. The effective date is August 1, 2018. The expiration date is July 31, 2019. The business address is 286 Stonewell Dr, Saint Johns, FL 32259-8388. The current status is inactive.

Basic Information

Licensee Name JASON P KOTULA PA
Credential ID 743370
Credential Number 23.001621
Credential Type Physician Assistant
Business Address 286 Stonewell Dr
Saint Johns
FL 32259-8388
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2005-04-18
Effective Date 2018-08-01
Expiration Date 2019-07-31
Refresh Date 2019-11-03

Other licenses

ID Credential Code Credential Type Issue Term Status
407705 CSP.0037639 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2005-06-20 2017-03-01 - 2019-02-28 LAPSED
754596 28.003810 Radiographer 2001-01-03 2001-01-03 - 2001-07-31 INACTIVE

Office Location

Street Address 286 STONEWELL DR
City SAINT JOHNS
State FL
Zip Code 32259-8388

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
April Nattinger 121 Castlegate Lane, St. Johns, FL 32259 Marital and Family Therapist 2020-06-01 ~ 2021-05-31
Timothy R Moore 1329 Wentworth Ave, Saint Johns, FL 32259 Professional Engineer 2020-02-01 ~ 2021-01-31
Henry Alexander Leder 332 N Lombardy Loop, Saint Johns, FL 32259 Controlled Substance Registration for Practitioner 2019-12-30 ~ 2021-02-28
Ekle A Small 429 Bridgeview Ter, Jacksonville, FL 32259 Professional Engineer 2020-02-01 ~ 2021-01-31
Matthew E Lane 243 North Arabella Way, Saint Johns, FL 32259 Professional Engineer 2020-02-01 ~ 2021-01-31
Siren R Chudgar 749 Peppervine Av, Saint Johns, FL 32259 Physician/surgeon 2019-08-01 ~ 2020-07-31
Jillian R Maki 1104 E Dandridge Ln, Saint Johns, FL 32259 Professional Engineer 2017-02-01 ~ 2018-01-31
Maria S Dance 440 East Kesley Lane, Jacksonville, FL 32259 Real Estate Salesperson 2008-06-01 ~ 2009-05-31
Todd D Mackey 305 Pinewood Ct, Jacksonville, FL 32259 Professional Engineer 1996-02-01 ~ 1997-01-31
Michael P Mullinix · The Stellar Group 185 Ivy Lakes Dr, Jacksonville, FL 32259 Professional Engineer 2009-02-01 ~ 2010-01-31
Find all Licenses in zip 32259

Competitor

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City SAINT JOHNS
Zip Code 32259
License Type Physician Assistant
License Type + County Physician Assistant + SAINT JOHNS

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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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