JACOB K MICKEY
Athletic Trainer


Address: 2203 Windsor Ridge Dr, Westborough, MA 01581-2346

JACOB K MICKEY (Credential# 1373820) is licensed (Athletic Trainer) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2018. The license expiration date date is March 31, 2019. The license status is INACTIVE.

Business Overview

JACOB K MICKEY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #54.001181. The credential type is athletic trainer. The effective date is April 1, 2018. The expiration date is March 31, 2019. The business address is 2203 Windsor Ridge Dr, Westborough, MA 01581-2346. The current status is inactive.

Basic Information

Licensee Name JACOB K MICKEY
Credential ID 1373820
Credential Number 54.001181
Credential Type Athletic Trainer
Business Address 2203 Windsor Ridge Dr
Westborough
MA 01581-2346
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2016-08-23
Effective Date 2018-04-01
Expiration Date 2019-03-31
Refresh Date 2019-07-04

Office Location

Street Address 2203 WINDSOR RIDGE DR
City WESTBOROUGH
State MA
Zip Code 01581-2346

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Ryan A Knestrick 4 Chauncy Circle, Westborough, MA 01581 Registered Nurse 2020-04-01 ~ 2021-03-31
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Dana Haagensen 12 Forbes Street, Westborough, MA 01581 Professional Engineer 2020-02-01 ~ 2021-01-31
Frederick A Scarborough 59 Piccadilly Way, Westborough, MA 01581 Professional Engineer 2020-02-01 ~ 2021-01-31
Jason Crespo 31 Moses Wheelock Ln, Westborough, MA 01581 Pharmacist 2020-02-01 ~ 2022-01-31
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Competitor

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City WESTBOROUGH
Zip Code 01581
License Type Athletic Trainer
License Type + County Athletic Trainer + WESTBOROUGH

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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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