KEVIN L PEDNEAULT (Credential# 744017) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
KEVIN L PEDNEAULT is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002268. The credential type is physician assistant. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 15 Fairmont St, Wethersfield, CT 06109-2212. The current status is active.
| Licensee Name | KEVIN L PEDNEAULT |
| Credential ID | 744017 |
| Credential Number | 23.002268 |
| Credential Type | Physician Assistant |
| Business Address |
15 Fairmont St Wethersfield CT 06109-2212 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2009-06-19 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-03-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 627543 | 10.E58643 | Registered Nurse | 1996-06-28 | 2020-05-01 - 2021-04-30 | ACTIVE |
| 536047 | CSP.0045674 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-07-02 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 15 FAIRMONT ST |
| City | WETHERSFIELD |
| State | CT |
| Zip Code | 06109-2212 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Laurel M Pickard | 7 Fairmont St, Wethersfield, CT 06109-2212 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Michael B Corry | 93 Hillsdale Avenue, Wethersfield, CT 06109-2212 | Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Angelo R Fazzina | 19 Fairmont St, Wethersfield, CT 06109-2212 | Plumbing & Piping Limited Journeyperson | 2008-11-01 ~ 2009-10-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan E Dimauro | 330 Ridge Rd, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Mary Boccacio | 174 Longvue Drive, Wethersfield, CT 06109 | Esthetician | ~ |
| Steven C Hine | 294 Hang Dog Ln, Wethersfield, CT 06109 | Architect | 2020-08-01 ~ 2021-07-31 |
| Karolina Monika Fitrzyk | 41 Mountain Laurel, Wethersfield, CT 06109 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Matthew R Dobos | 33 Oxford St, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Samantha Grabbe | 17 Rockland St, Wethersfield, CT 06109 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Judith M Martz | 307 Nott Street, Wethersfield, CT 06109 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Ups Store (the) | 1077 Silas Deane Hwy, Wethersfield, CT 06109 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Amber H Washington | 103 Parkview Drive, Wethersfield, CT 06109 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Kathleen A Mullady · Brancati | 75 Dale Rd, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06109 | |||
| City | WETHERSFIELD |
| Zip Code | 06109 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + WETHERSFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kevin M Chandon Pa-c | 79 Judson Ave, Woodbury, CT 06798-2713 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Kevin Stetter | 110 Beachview Ave Unit 218, Bridgeport, CT 06605-3263 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Kevin F Ryan | 12 Walker Road, Ware, MA 01082 | Physician Assistant | 1997-08-22 ~ 1998-09-30 |
| Kevin M. Kattau | 20 Hooper Ct, East Northport, NY 11731-4914 | Physician Assistant | 2011-09-22 ~ 2012-01-31 |
| Kevin R Mcdonald | 100 Oakview Drive, Trumbull, CT 06611 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Kevin Eric Hwang | 17 Lyon Ave, Greenwich, CT 06830-6206 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Kevin E Wood | 43 Terese Rd, Beacon Falls, CT 06403-1240 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Kevin C Calyer Pa | 460 Hartford Tpke, Vernon, CT 06066 | Physician Assistant | 2006-02-16 ~ 2007-04-30 |
| Kevin R Lager | 308 Eagles Ridge Rd, Brewster, NY 10509-1132 | Physician Assistant | 2019-12-01 ~ 2020-11-30 |
| Kevin Patrick Rooney | 4 Penn Place, Rocky Hill, CT 06067 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
Please comment or provide details below to improve the information on KEVIN L PEDNEAULT.
| 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).