SAMANTHA L WHALEN
Physician Assistant


Address: 9 Brenda Drive, Westfield, MA 01085-3754

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.

Business Overview

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.

Basic Information

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

Other licenses

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

Office Location

Street Address 9 Brenda Drive
City WESTFIELD
State MA
Zip Code 01085-3754

Licenses in the same zip code

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

Licenses in the same zip code

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
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Competitor

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City WESTFIELD
Zip Code 01085
License Type Physician Assistant
License Type + County Physician Assistant + WESTFIELD

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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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