KIMBERLY L BELLAVANCE (Credential# 1047470) 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.
KIMBERLY L BELLAVANCE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002714. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 35 Farmwood Drive, Colchester, CT 06415. The current status is active.
Licensee Name | KIMBERLY L BELLAVANCE |
Credential ID | 1047470 |
Credential Number | 23.002714 |
Credential Type | Physician Assistant |
Business Address |
35 Farmwood Drive Colchester CT 06415 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2012-01-24 |
Effective Date | 2020-06-01 |
Expiration Date | 2021-05-31 |
Refresh Date | 2020-06-02 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1047843 | CSP.0051876 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2012-01-26 | 2019-03-11 - 2021-02-28 | ACTIVE |
Street Address | 35 Farmwood Drive |
City | Colchester |
State | CT |
Zip Code | 06415 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Ashley Shattuck | 66 South Road, Colchester, CT 06415 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
Linda Smith · Lamb | 25 Loomis Road, Colchester, CT 06415 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
Vincent Vespa Jr | 671 Norwich Ave, Colchester, CT 06415 | Sub-surface Sewage Installer | 2020-09-01 ~ 2021-08-31 |
Deborah L Strong · Bowen | 98 Lebanon Avenue, Colchester, CT 06415 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
Lucy A Boisse | 115 Stanavage Road, Colchester, CT 06415 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
Alicia R Bohnenkamper | 906 Canterbury Lane, Colchester, CT 06415 | Notary Public Appointment | 2011-09-28 ~ 2016-09-30 |
Anna M Sofia | 75 B Elmwood Heights, Colcheshter, CT 06415 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
J J Noels Supermarket | 15 Broadway, Colchester, CT 06415 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Linda S Kvasnik | 69 Colburn Dr, Colchester, CT 06415 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
James W Bansemer · General Builders & Remodelers | 87 O'connell Road, Colchester, CT 06415 | Home Improvement Contractor | 2020-06-25 ~ 2020-11-30 |
Find all Licenses in zip 06415 |
City | Colchester |
Zip Code | 06415 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + Colchester |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
John Bellavance · Bellavance Trucking & Excavating | 378 N Main Street, Moosup, CT 06354 | New Home Construction Contractor | 2011-10-01 ~ 2013-09-30 |
Kimberly Keane | Kimberly Keane Pa-c, Derby, CT 06418 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
Kathryn L Bellavance | 389 Sterling Hill Rd, Moosup, CT 06354-2033 | Physical Therapist Assistant | 2020-07-01 ~ 2021-06-30 |
Bellavance Properties LLC · Turtles Taco Shop | 178 Providence St, Putnam, CT 06260-1512 | Frozen Dessert Retailer | 2013-01-01 ~ 2013-12-31 |
Barry T. Bellavance, Cpa | 30 Park Street, Box 685, Putnam, CT 06260 | Certified Public Accountant Firm Permit | 2005-01-01 ~ 2005-12-31 |
Bellavance & King Cpa's LLC | 30 Park Street, Putnam, CT 06260 | Certified Public Accountant Firm Permit | 2008-01-01 ~ 2008-12-31 |
Bellavance Farm LLC | 318 Sterling Hill Rd, Moosup, CT 06354-2034 | Hemp Grower | 2019-12-31 ~ 2021-12-31 |
Bellavance Transportation LLC | 378 N Main St, Moosup, CT 06354-1122 | Operator of Weighing & Measuring Devices | 2012-08-01 ~ 2013-07-31 |
Bellavance Excavating | 378 N. Main St., Moosup, CT 06354 | Demolition Contractor | 2012-07-01 ~ 2013-06-30 |
Kimberly A Sweezy | 21 Collier Rd, Wethersfield, CT 06109-3525 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
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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).