SAMANTHA M MOBERGER (Credential# 1329063) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
SAMANTHA M MOBERGER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003509. The credential type is physician assistant. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 149 Wickham Road, Glastonbury, CT 06033. The current status is active.
| Licensee Name | SAMANTHA M MOBERGER |
| Credential ID | 1329063 |
| Credential Number | 23.003509 |
| Credential Type | Physician Assistant |
| Business Address |
149 Wickham Road Glastonbury CT 06033 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2016-01-25 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1332121 | CSP.0062063 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-02-08 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 149 Wickham Road |
| City | Glastonbury |
| State | CT |
| Zip Code | 06033 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Vanessa Segal | 46 Salem Court, Glastonbury, CT 06033 | Hairdresser/cosmetician | ~ |
| Laura Nadeau | 3641 Hebron Ave, Glastonbury, CT 06033 | Respiratory Care Practitioner | 2020-08-01 ~ 2021-07-31 |
| Abigail Lynn Hubbard | 55 Brookview Drive, Glastonbury, CT 06033 | Emergency Medical Technician | ~ |
| Maureen E Booth | 36 Hubbard Run Drive, Glastonbury, CT 06033 | Speech and Language Pathologist | 2020-07-01 ~ 2021-06-30 |
| Wendy B Johnson | 1789 Main St, Glastonbury, CT 06033 | Architect | 2020-08-01 ~ 2021-07-31 |
| Michael D Devanney Pa | 28 Evergreen Ln, Glastonbury, CT 06033 | Physician Assistant | 2020-09-01 ~ 2021-08-31 |
| Sophie C Gomez · Pirog | 81 Three Mile Rd, Glastonbury, CT 06033 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Jennifer R Briones | 90 Deerfield Drive, Glastonbury, CT 06033 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Munson's Chocolates | 135 Glastonbury Blvd, Glastonbury, CT 06033 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Yulhun Sung | 245 Griswold St Unit A, Glastonbury, CT 06033 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Find all Licenses in zip 06033 | |||
| City | Glastonbury |
| Zip Code | 06033 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + Glastonbury |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Samantha Ann Siva | 40 Primrose St Apt 2, White Plains, NY 10606-1620 | Physician Assistant | ~ |
| Samantha A Carofano | 26 Glenwood, Plainview, NY 11803 | Physician Assistant | 2014-11-01 ~ 2015-10-31 |
| Samantha A Holzman | 3 Farmstead Ln, Farmington, CT 06032-2819 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Samantha J Sinche | 11 Waterbury Ln, Darien, CT 06820-3232 | Physician Assistant | 2016-11-01 ~ 2017-11-30 |
| Samantha L Whalen | 9 Brenda Drive, Westfield, MA 01085-3754 | Physician Assistant | 2016-08-01 ~ 2017-07-31 |
| Samantha Ann Couillard | 315 Woodfield Xing, Glastonbury, CT 06033-1464 | Physician Assistant | 2020-06-15 ~ 2021-01-31 |
| Samantha Wenta | 708 Lexington Blvd, Bethel, CT 06801 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Physician Assistant Foundation of The American Academy of Physician Assistants | 2318 Mill Rd Ste 1300, Alexandria, VA 22314-6868 | Public Charity | 2019-12-01 ~ 2020-11-30 |
| Samantha M Jordan | 777 Laura Dr, Marion, OH 43302 | Physical Therapist Assistant | 2020-05-01 ~ 2021-04-30 |
| Samantha L Sailer | 55 Lambert Dr, Stratford, CT 06614-2616 | 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).