SAMANTHA L WHALEN (Credential# 1123520) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2016. The license expiration date date is July 31, 2017. The license status is INACTIVE.
SAMANTHA L WHALEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002833. The credential type is physician assistant. The effective date is August 1, 2016. The expiration date is July 31, 2017. The business address is 9 Brenda Drive, Westfield, MA 01085-3754. The current status is inactive.
Licensee Name | SAMANTHA L WHALEN |
Credential ID | 1123520 |
Credential Number | 23.002833 |
Credential Type | Physician Assistant |
Business Address |
9 Brenda Drive Westfield MA 01085-3754 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 2012-09-25 |
Effective Date | 2016-08-01 |
Expiration Date | 2017-07-31 |
Refresh Date | 2017-11-03 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1125629 | CSP.0053825 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2012-10-04 | 2015-03-01 - 2017-02-28 | INACTIVE |
Street Address | 9 Brenda Drive |
City | WESTFIELD |
State | MA |
Zip Code | 01085-3754 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Nicole M Hentnick | 84 Plantation Cir, Westfield, MA 01085-3754 | Physical Therapist | 2019-10-01 ~ 2020-09-30 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Katie M Winslow | 33 Cara Lane, Westfield, MA 01085 | Registered Nurse | 2020-06-20 ~ 2021-06-30 |
Diana P Wigham | 1031 East Mountain Road, Westfield, MA 01085 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Cathy A Roche | 56 Pequot Point Rd., Westfield, MA 01085 | Physical Therapist Assistant | 2020-08-01 ~ 2021-07-31 |
James Richard Vollinger | 139 Union Street, Westfield, MA 01085 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Sharon L Scavotto | 196 Tannery Road, Westfield, MA 01085 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
Christopher J Ferrero | 64 Ridge Trail Rd, Westfield, MA 01085 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
Aimee C Tompkins | 2 Birch Terr, Westfield, MA 01085 | Real Estate Salesperson | 2019-06-01 ~ 2020-05-31 |
Jennifer B Wilson | 33 Raymond Cir, Westfield, MA 01085 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Patricia S Daley | 152 Elizabeth Ave, Westfield, MA 01085 | Registered Nurse | 2020-01-01 ~ 2020-12-31 |
Cheryl-ann J Koval | 171 Wildflower Cir, Westfield, MA 01085 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Find all Licenses in zip 01085 |
City | WESTFIELD |
Zip Code | 01085 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + WESTFIELD |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Samantha J Sinche | 11 Waterbury Ln, Darien, CT 06820-3232 | Physician Assistant | 2016-11-01 ~ 2017-11-30 |
Samantha A Holzman | 3 Farmstead Ln, Farmington, CT 06032-2819 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
Samantha A Carofano | 26 Glenwood, Plainview, NY 11803 | Physician Assistant | 2014-11-01 ~ 2015-10-31 |
Samantha Ann Siva | 40 Primrose St Apt 2, White Plains, NY 10606-1620 | Physician Assistant | ~ |
Samantha M Moberger | 149 Wickham Road, Glastonbury, CT 06033 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
Samantha Wenta | 708 Lexington Blvd, Bethel, CT 06801 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
Samantha Ann Couillard | 315 Woodfield Xing, Glastonbury, CT 06033-1464 | Physician Assistant | 2020-06-15 ~ 2021-01-31 |
Whalen LLC · Whalen Furniture Manufacturing | 1578 Air Wing Road, San Diego, CA 92154 | Importer of Bedding & Upholstered Furniture | 2020-05-01 ~ 2021-04-30 |
Kevin W Whalen · Whalen Construction | 6 Fir Drive, New Milford, CT 06776 | Home Improvement Contractor | ~ 1995-05-01 |
Mary E Whalen | 20 Sybil Ave, Branford, CT 06405-5330 | Occupational Therapist Assistant | 2019-08-01 ~ 2021-07-31 |
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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).