DANIELLE M TABAKA (Credential# 743447) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
DANIELLE M TABAKA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001698. The credential type is physician assistant. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 11 Arkona Dr, Higganum, CT 06441-4479. The current status is active.
| Licensee Name | DANIELLE M TABAKA |
| Credential ID | 743447 |
| Credential Number | 23.001698 |
| Credential Type | Physician Assistant |
| Business Address |
11 Arkona Dr Higganum CT 06441-4479 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2005-10-14 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-05-21 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 414921 | CSP.0038239 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-10-31 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 874180 | 71.000184 | Advanced Emergency Medical Technician | 2001-02-27 | 2005-04-01 - 2006-12-31 | INACTIVE |
| 873090 | 70.990111 | Emergency Medical Technician | 1998-12-22 | 2001-01-02 - 2002-12-31 | INACTIVE |
| Street Address | 11 ARKONA DR |
| City | HIGGANUM |
| State | CT |
| Zip Code | 06441-4479 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Raymond A Roberge | 27 Arkona Dr, Higganum, CT 06441-4479 | Emergency Medical Responder | 2019-04-01 ~ 2022-03-31 |
| Michelle A Roberge | 27 Arkona Dr, Higganum, CT 06441-4479 | Emergency Medical Technician | 2018-05-29 ~ 2021-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robert J Grasso | 44 Thorne Wood Road, Higganum, CT 06441 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Julie A Hajek | 364 Candlewood Hill Road, Higganum, CT 06441 | Dental Hygienist | 2020-05-01 ~ 2021-04-30 |
| Timothy L Brewer | 144 Dublin Hill Rd, Higganum, CT 06441 | Architect | 2020-08-01 ~ 2021-07-31 |
| Michael P Fortuna | 58 Killingworth Road, Higganum, CT 06441 | Architect | 2020-08-01 ~ 2021-07-31 |
| Kelli S Botteon · Brown | 23 Depot Road, Higganum, CT 06441 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| David Wysocki | Po Box 743, Higganum, CT 06441 | Demolition Contractor | 2020-07-01 ~ 2021-06-30 |
| Theresa M Beeman | 28 Teaberry Court, Higganum, CT 06441 | Dental Hygienist | 2020-09-01 ~ 2021-08-31 |
| Ronald Hajek | 364 Candlewood Hill, Higganum, CT 06441 | Sub-surface Sewage Installer | 2020-07-01 ~ 2021-06-30 |
| Heather M Herrington · Ridgeway | 186 Brainard Hill Rd, Higganum, CT 06441 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Brenda L Marinan | P O Box 605, Higganum, CT 06441 | Nursing Home Administrator | 2020-09-01 ~ 2022-08-31 |
| Find all Licenses in zip 06441 | |||
| City | HIGGANUM |
| Zip Code | 06441 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + HIGGANUM |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Danielle Kerr | 71 Ireland Dr, Coventry, CT 06238-2548 | Physician Assistant | ~ |
| Danielle Holic | 6 Woodcliff Dr, Stormville, NY 12582-5713 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Danielle Boley | 72 Huie St Nw, Concord, NC 28027-5325 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Danielle M Tashakori | 740 Mix Ave Unit 211, Hamden, CT 06514-2282 | Physician Assistant | 2014-06-01 ~ 2015-05-31 |
| Danielle R Lauzze Pa-c | 64 Avonwood Rd Apt A12, Avon, CT 06001-2079 | Physician Assistant | 2014-06-01 ~ 2015-05-31 |
| Danielle Sarah Desmarais | 25 Old Towne Rd, Cheshire, CT 06410-3122 | Physician Assistant | ~ |
| Danielle D Soneson | 80 Seymour Street, Hartford, CT 06102 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Danielle M Kirei | 15 Lantern Drive, Seymour, CT 06483 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Danielle Doucette | 38 Saddlewood Drive, Hillsdale, NJ 07642 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Danielle M Cowee | 16 Morse Road, Manchester, CT 06040 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
Please comment or provide details below to improve the information on DANIELLE M TABAKA.
| 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).