MARISSA F FORTE
Physician Assistant


Address: 10 Topaz Ct, New City, NY 10956-7030

MARISSA F FORTE (Credential# 1313932) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2017. The license expiration date date is November 30, 2018. The license status is INACTIVE.

Business Overview

MARISSA F FORTE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003558. The credential type is physician assistant. The effective date is December 1, 2017. The expiration date is November 30, 2018. The business address is 10 Topaz Ct, New City, NY 10956-7030. The current status is inactive.

Basic Information

Licensee Name MARISSA F FORTE
Credential ID 1313932
Credential Number 23.003558
Credential Type Physician Assistant
Business Address 10 Topaz Ct
New City
NY 10956-7030
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2016-04-18
Effective Date 2017-12-01
Expiration Date 2018-11-30
Refresh Date 2019-03-05

Office Location

Street Address 10 TOPAZ CT
City NEW CITY
State NY
Zip Code 10956-7030

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Lucy Villa 5 Prides Crossing, New City, NY 10956 Dentist 2020-03-01 ~ 2021-02-28
Perry Evan Schattman 2 Glenmere Rd, New City, NY 10956 Emergency Medical Technician ~
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City NEW CITY
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License Type Physician Assistant
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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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