MARTY D WALLACE (Credential# 786736) is licensed (Physical Therapist Assistant) with Connecticut Department of Consumer Protection. The license effective date is February 21, 2001. The license expiration date date is November 1, 2006. The license status is INACTIVE.
MARTY D WALLACE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #63.000595. The credential type is physical therapist assistant. The effective date is February 21, 2001. The expiration date is November 1, 2006. The business address is 506 Forest St., Monroe, GA 30655. The current status is inactive.
| Licensee Name | MARTY D WALLACE |
| Credential ID | 786736 |
| Credential Number | 63.000595 |
| Credential Type | Physical Therapist Assistant |
| Business Address |
506 Forest St. Monroe GA 30655 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1997-07-07 |
| Effective Date | 2001-02-21 |
| Expiration Date | 2006-11-01 |
| Refresh Date | 2009-07-08 |
| Street Address | 506 Forest St. |
| City | Monroe |
| State | GA |
| Zip Code | 30655 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Carole L Austin | 419 Lakeshore Drive, Monroe, GA 30655 | Registered Nurse | 2008-04-07 ~ 2009-05-31 |
| Sharon L Hayles-richards | 667 Michael Circle, Monroe, GA 30655 | Licensed Practical Nurse | 2002-06-17 ~ 2003-06-30 |
| Premier Wholsale LLC | 215 East Church Street, Monroe, GA 30655 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2007-07-01 ~ 2008-06-30 |
| Globexpharma LLC | 1304 E Broad St, Monroe, GA 30655 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2001-06-14 ~ 2002-06-30 |
| Gloria Osei | 403 Lakeshore Dr, Monroe, GA 30655 | Registered Nurse | 2016-11-01 ~ 2017-10-31 |
| Cochran Wholesale Pharmaceutical LLC | 1304 S Broad St, Monroe, GA 30655-2222 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Angel Food Ministries Inc. | 1620 S Broad St, Monroe, GA 30655-2263 | Public Charity | 2010-06-01 ~ 2011-11-30 |
| Premier Care · Pkc Acquisition, Inc. | 221 Plaza Dr, Monroe, GA 30655-3184 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Bart S Sargent | 2760 Hestertown Rd, Monroe, GA 30655-7633 | Architect | 2020-08-01 ~ 2021-07-31 |
| Isaac O Osei | 403 Lakeshore Dr, Monroe, GA 30655-7709 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Find all Licenses in zip 30655 | |||
| City | Monroe |
| Zip Code | 30655 |
| License Type | Physical Therapist Assistant |
| License Type + County | Physical Therapist Assistant + Monroe |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robert D Wallace | 3 Hart Rd, Guilford, CT 06437-1129 | Physical Therapist Assistant | 2019-08-01 ~ 2020-07-31 |
| Eric J Irizarry | 19 Wallace Ave., Mount Vernon, NY 10552 | Physical Therapist Assistant | 2004-07-13 ~ 2006-11-01 |
| Michell N Wallace | 2810 Old Town Rd, Bridgeport, CT 06606-1243 | Physical Therapist Assistant | 2020-05-01 ~ 2021-04-30 |
| Brandon Tyler Smith | 24 Wallace Row # 1b, Wallingford, CT 06492-3137 | Physical Therapist Assistant | 2020-06-17 ~ 2020-08-31 |
| Nicholas Wallace Scott | 15 Freedom Way, Niantic, CT 06357-1044 | Physical Therapist Assistant | 2020-01-17 ~ 2020-09-30 |
| Marty Febos | 48 Lagoon Place, East Islip, NY 11730 | Physical Therapist | 1999-01-28 ~ 2000-02-29 |
| Meredith Roche | 8 Marty Lane, South Windsor, CT 06074 | Physical Therapist | 2020-07-01 ~ 2021-06-30 |
| Stacey G Heenie | 60 Wallace Row, Wallingford, CT 06492 | Occupational Therapist Assistant | 2019-08-01 ~ 2021-07-31 |
| Susan D Wallace | P.o. Box 192, Rudy, AR 72952 | Physical Therapist | ~ 1996-11-30 |
| Linda J Wallace | 96 Regency Park Dr, Agawam, MA 01001 | Occupational Therapist Assistant | 1997-09-02 ~ 1999-07-31 |
Please comment or provide details below to improve the information on MARTY D WALLACE.
| 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).