ELLEN BETH (Credential# 1005514) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
ELLEN BETH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002596. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 136 Old Chester Rd, Haddam, CT 06438. The current status is active.
| Licensee Name | ELLEN BETH |
| Credential ID | 1005514 |
| Credential Number | 23.002596 |
| Credential Type | Physician Assistant |
| Business Address |
136 Old Chester Rd Haddam CT 06438 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2011-07-18 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-03-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1042339 | CSP.0051708 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2011-11-30 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 136 Old Chester Rd |
| City | Haddam |
| State | CT |
| Zip Code | 06438 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alan H Lozano Pa | 136 Old Chester Rd, Haddam, CT 06438-1337 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| William E Buganski | 19 Ruth Hill Road, Haddam, CT 06438 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| Alma Sabovic | 55 Hubbard Rd, Haddam, CT 06438 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Vera K Davidson | 47 Dickinson Road, Haddam, CT 06438 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Rachel E Decker | 377 Plains Rd, Haddam, CT 06438 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Gregory P Shields | 172 Hayden Hill Rd, Haddam, CT 06438 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Joyce P Houska | 1 Filley Road, Haddam, CT 06438 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Cooking Company (the) | 1610 Saybrook Rd, Haddam, CT 06438 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Creative Cakes By Donna | Route 154, Haddam, CT 06438 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Susan A Shea | 81 Walkley Hill Road, Haddam, CT 06438 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Heather K Marica | 107 Old Cart Road, Haddam, CT 06438 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06438 | |||
| City | Haddam |
| Zip Code | 06438 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + Haddam |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Beth-ellen Preisner | 76r Dunn Hill Road, Durham, CT 06422 | Family Child Care Assistant | 1997-04-30 ~ 1997-04-30 |
| Beth M Rosenberg Pa | 14 Westview Dr, Enfield, CT 06082 | Physician Assistant | 2004-08-09 ~ 2005-09-30 |
| Beth A Buyea Pa | 13 Middlefield Rd, Durham, CT 06422 | Physician Assistant | 2006-05-25 ~ 2007-07-31 |
| Beth Harple | 10 Homestead Ave, Danbury, CT 06810 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Beth Degarmo | 328 Russell St Apt 2, Madison, WI 53704-5313 | Physician Assistant | 2019-04-01 ~ 2020-03-31 |
| Beth A Cross | 14 Todd's Road, Ridgefield, CT 06877 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Ellen R Seitelman | P.o. Box 347, Albion, RI 02802 | Physician Assistant | 2008-07-28 ~ 2009-07-31 |
| Ellen Debra Matteson | 160 Hawley Ln, Trumbull, CT 06611-5300 | Physician Assistant | ~ |
| Ellen Gingerella | 1 Pequot Ave, Mystic, CT 06355-2421 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Courtney Beth Stewart | 1751 Earl Core Rd., Morgantown, WV 26505 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
Please comment or provide details below to improve the information on ELLEN BETH.
| 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).