GEORGE A LOPEZ PA (Credential# 743970) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2019. The license expiration date date is November 30, 2020. The license status is ACTIVE.
GEORGE A LOPEZ PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002221. The credential type is physician assistant. The effective date is December 1, 2019. The expiration date is November 30, 2020. The business address is 1759 W End Ave, New Hyde Park, NY 11040-4024. The current status is active.
Licensee Name | GEORGE A LOPEZ PA |
Credential ID | 743970 |
Credential Number | 23.002221 |
Credential Type | Physician Assistant |
Business Address |
1759 W End Ave New Hyde Park NY 11040-4024 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2009-01-12 |
Effective Date | 2019-12-01 |
Expiration Date | 2020-11-30 |
Refresh Date | 2019-08-27 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
897559 | CSP.0046789 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-10-19 | 2009-10-19 - 2011-02-28 | INACTIVE |
Street Address | 1759 W END AVE |
City | NEW HYDE PARK |
State | NY |
Zip Code | 11040-4024 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Hibah Aijaz | 54 Herbert Drive, New Hyde Park, NY 11040 | Physician/surgeon | 2018-12-03 ~ 2019-12-31 |
Anna Marie Jardine · Harvey | 39 Flag Lane, New Hyde Park, NY 11040 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
Bruce H Safran | 2101 Royal Court, North Hills, NY 11040 | Dentist | 2020-07-01 ~ 2021-06-30 |
Roy B Cohen | 105 Elm La, New Hyde Park, NY 11040 | Optometrist | 2020-04-01 ~ 2021-03-31 |
Poko Management Corp | 2417 Jericho Tpke, New Hyde Park, NY 11040 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
Michael A. Bianco | 50 Rose Place, Garden City Park, NY 11040 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Ananthakumar Thillainathan | 5 Camden Place, Newhydepark, NY 11040 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Deborah J Dolan | 1106 Jericho Tpke, New Hyde Park, NY 11040 | Tax Preparer/facilitator Permit | 2020-02-11 ~ 2022-02-28 |
Gracemon Kuriakose | 1042 Hillside Blvd, New Hyde Park, NY 11040 | Tax Preparer/facilitator Permit | 2020-02-11 ~ 2022-02-28 |
Johnson D Daniel | 121 South 9th Street, New Hyde Park, NY 11040 | Tax Preparer/facilitator Permit | 2020-02-12 ~ 2022-02-28 |
Find all Licenses in zip 11040 |
City | NEW HYDE PARK |
Zip Code | 11040 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + NEW HYDE PARK |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Kristen M Lopez | 747 3rd St Ne, Washington, DC 20002-4311 | Physician Assistant | 2016-06-01 ~ 2017-05-31 |
Nancy Lopez Pa | 815 South Rd, Westbrookville, NY 12785-0448 | Physician Assistant | 2015-08-01 ~ 2016-07-31 |
Kristina Lopez | 109 Kaye Vue Drive, Hamden, CT 06514 | Physician Assistant | ~ 1996-01-31 |
Rolando R Lopez | 22 Tyler City Rd, Orange, CT 06477 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
Peter Joseph Lopez Pa | 63 Pinacle Rd, Glastonbury, CT 06033-2521 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
Diane C Lopez-morgillo · Lopez | 41 George Street, East Haven, CT 06512 | Registered Nurse | 2020-03-01 ~ 2021-02-28 |
Julia M Friedman Pa | 207 George St, Middletown, CT 06457 | Physician Assistant | 2010-07-01 ~ 2011-06-30 |
George M Morales | 40 Prospect Ave, Norwalk, CT 06850-3737 | Physician Assistant | 2010-07-22 ~ 2011-06-30 |
Clinton B. Wheeler | 207 George St Apt 432, Middletown, CT 06457-3599 | Physician Assistant | 2010-11-01 ~ 2011-11-30 |
George D Easter Jr | 160 Marsh Rd, Litchfield, CT 06759 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
Please comment or provide details below to improve the information on GEORGE A LOPEZ PA.
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).