KAITLYN E BOOTH PA-C
Physician Assistant


Address: 225 E 95th St Apt 31f, New York, NY 10128-4010

KAITLYN E BOOTH PA-C (Credential# 1028752) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2016. The license expiration date date is March 31, 2017. The license status is INACTIVE.

Business Overview

KAITLYN E BOOTH PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002632. The credential type is physician assistant. The effective date is April 1, 2016. The expiration date is March 31, 2017. The business address is 225 E 95th St Apt 31f, New York, NY 10128-4010. The current status is inactive.

Basic Information

Licensee Name KAITLYN E BOOTH PA-C
Credential ID 1028752
Credential Number 23.002632
Credential Type Physician Assistant
Business Address 225 E 95th St Apt 31f
New York
NY 10128-4010
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2011-09-09
Effective Date 2016-04-01
Expiration Date 2017-03-31
Refresh Date 2017-07-04

Other licenses

ID Credential Code Credential Type Issue Term Status
1037127 CSP.0051534 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2011-10-13 2015-03-01 - 2017-02-28 INACTIVE

Office Location

Street Address 225 E 95TH ST APT 31F
City NEW YORK
State NY
Zip Code 10128-4010

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Competitor

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City NEW YORK
Zip Code 10128
License Type Physician Assistant
License Type + County Physician Assistant + NEW YORK

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Dataset Information

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).

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