CHARLES M ANDOLA III PA (Credential# 744030) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
CHARLES M ANDOLA III PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002281. The credential type is physician assistant. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 204 Wardwell St, Stamford, CT 06902-5247. The current status is active.
| Licensee Name | CHARLES M ANDOLA III PA |
| Credential ID | 744030 |
| Credential Number | 23.002281 |
| Credential Type | Physician Assistant |
| Business Address |
204 Wardwell St Stamford CT 06902-5247 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2009-07-08 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-12-10 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 900464 | CSP.0046871 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-11-17 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 204 WARDWELL ST |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902-5247 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Francisca A Pinamang | 204 Wardwell St, Stamford, CT 06902 | Licensed Practical Nurse | 2020-02-01 ~ 2021-01-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Israel W Andola Pa | 204 Wardwell St Unit 5, Stamford, CT 06902-5247 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Mismak M Abebe | 204 Wardwell St Unit 1, Stamford, CT 06902-5247 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Kimberly J Styslinger | 204 Wardwell St # 3, Stamford, CT 06902-5247 | Emergency Medical Technician | 2020-04-01 ~ 2023-03-31 |
| Marco L Califano | 222 Wardwell St, Stamford, CT 06902-5247 | Emergency Medical Responder | 2019-03-06 ~ 2021-12-31 |
| Adey M Abebe | 204 Wardwell St Unit 1, Stamford, CT 06902-5247 | Controlled Substance Registration for Practitioner | 2019-11-26 ~ 2021-02-28 |
| Meseret A Ashagre | 204 Wardwell St Unit 1, Stamford, CT 06902-5247 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Michael J Califano | 222 Wardwell St, Stamford, CT 06902-5247 | Emergency Medical Responder | 2013-11-21 ~ 2016-07-01 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeris Maydeli Flores | 153 Fairfield Av, Stamford, CT 06902 | Nail Technician | ~ |
| Reynaldo De La Cruz | 64 Brookside Drive, Stamford, CT 06902 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Darren J Petillo | 5 Hundley Court, Stamford, CT 06902 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Antonios Restaurant | 405 West Main St, Stamford, CT 06902 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Edward Smith | 184 Fairfield Ave., Stamford, CT 06902 | Home Improvement Contractor | ~ |
| Margaret A Dorrance | 24c Hamilton Court, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carolyn Maguire | 48 Nelson St, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Evelyne Joassin | 17 George St., Stamford, CT 06902 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Andrea Bynoe | 34 Melrose Pl, Stamford, CT 06902 | Notary Public Appointment | 1994-04-06 ~ 1999-04-30 |
| Ravi K Ahuja | 296 Westover Rd, Stamford, CT 06902 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06902 | |||
| City | STAMFORD |
| Zip Code | 06902 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + STAMFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Israel W Andola Pa | 204 Wardwell St Unit 5, Stamford, CT 06902-5247 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Charles Edward | 99 26 193 St, Hollis, NY 11423-3216 | Physician Assistant | 2011-12-12 ~ 2012-08-31 |
| Charles J Severo | 115 Beachland Avenue, Milford, CT 06460 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Charles Joseph Braun Jr. | 103 Ash Street, Cortlandt Manor, NY 10567 | Physician Assistant | ~ |
| Charles A Engle | 9 Humber Hill Rd, Danbury, CT 06810-5172 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Janine J Zawisny | 159 Charles Ave, Staten Island, NY 10302 | Physician Assistant | 2010-01-13 ~ 2010-07-31 |
| Charles Dupaix | 40 Prospect Ave Bldg #1 Apt 4-f, Norwalk, CT 06850-3737 | Physician Assistant | 2016-05-01 ~ 2017-04-30 |
| Charles R Park | 1283 Whirlwind Hill Rd, Wallingford, CT 06492 | Physician Assistant | 2016-10-01 ~ 2017-09-30 |
| Charles Robert Barnes | 112 Baker St, Johnson City, NY 13790-1904 | Physician Assistant | 2016-07-21 ~ 2017-07-31 |
| Charles Barnicoat Pa | 4483 Snowy Egret Drive, Naples, FL 34119 | Physician Assistant | 2011-02-01 ~ 2012-01-31 |
Please comment or provide details below to improve the information on CHARLES M ANDOLA III 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).