DANIELLE M TASHAKORI
Physician Assistant


Address: 740 Mix Ave Unit 211, Hamden, CT 06514-2282

DANIELLE M TASHAKORI (Credential# 1118814) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2014. The license expiration date date is May 31, 2015. The license status is INACTIVE.

Business Overview

DANIELLE M TASHAKORI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002817. The credential type is physician assistant. The effective date is June 1, 2014. The expiration date is May 31, 2015. The business address is 740 Mix Ave Unit 211, Hamden, CT 06514-2282. The current status is inactive.

Basic Information

Licensee Name DANIELLE M TASHAKORI
Credential ID 1118814
Credential Number 23.002817
Credential Type Physician Assistant
Business Address 740 Mix Ave Unit 211
Hamden
CT 06514-2282
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2012-09-17
Effective Date 2014-06-01
Expiration Date 2015-05-31
Refresh Date 2015-09-11

Other licenses

ID Credential Code Credential Type Issue Term Status
1125893 CSP.0053829 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2012-10-04 2013-03-01 - 2015-02-28 INACTIVE

Office Location

Street Address 740 MIX AVE UNIT 211
City HAMDEN
State CT
Zip Code 06514-2282

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Competitor

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City HAMDEN
Zip Code 06514
License Type Physician Assistant
License Type + County Physician Assistant + HAMDEN

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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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