MARY LYNN E MANDUCA
Athletic Trainer


Address: 62 Causeway Ter, Leominster, MA 01453-1712

MARY LYNN E MANDUCA (Credential# 1296718) is licensed (Athletic Trainer) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2018. The license expiration date date is April 30, 2019. The license status is INACTIVE.

Business Overview

MARY LYNN E MANDUCA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #54.001038. The credential type is athletic trainer. The effective date is May 1, 2018. The expiration date is April 30, 2019. The business address is 62 Causeway Ter, Leominster, MA 01453-1712. The current status is inactive.

Basic Information

Licensee Name MARY LYNN E MANDUCA
Credential ID 1296718
Credential Number 54.001038
Credential Type Athletic Trainer
Business Address 62 Causeway Ter
Leominster
MA 01453-1712
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2015-07-06
Effective Date 2018-05-01
Expiration Date 2019-04-30
Refresh Date 2019-08-03

Office Location

Street Address 62 CAUSEWAY TER
City LEOMINSTER
State MA
Zip Code 01453-1712

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Kevin Wachira Githinji 9 Crystal Ave, Leominster, MA 01453 Registered Nurse 2020-01-21 ~ 2020-07-31
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Sr Paulette Gariepy 400 Atlantic Avenue Apt 24 G, Leominster, MA 01453 Notary Public Appointment 2004-04-01 ~ 2009-03-31
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Competitor

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City LEOMINSTER
Zip Code 01453
License Type Athletic Trainer
License Type + County Athletic Trainer + LEOMINSTER

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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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