JASON ROBERT PERICAK (Credential# 1381420) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2018. The license expiration date date is December 31, 2018. The license status is INACTIVE.
JASON ROBERT PERICAK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.055980. The credential type is physician/surgeon. The effective date is January 1, 2018. The expiration date is December 31, 2018. The business address is 199 Park Club Lane Suite 300, Williamsville, NY 14221. The current status is inactive.
| Licensee Name | JASON ROBERT PERICAK |
| Credential ID | 1381420 |
| Credential Number | 1.055980 |
| Credential Type | Physician/Surgeon |
| Business Address |
199 Park Club Lane Suite 300 Williamsville NY 14221 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2016-12-01 |
| Effective Date | 2018-01-01 |
| Expiration Date | 2018-12-31 |
| Refresh Date | 2019-04-05 |
| Street Address | 199 Park Club Lane Suite 300 |
| City | Williamsville |
| State | NY |
| Zip Code | 14221 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Keyur Suryakant Shah | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2018-11-01 ~ 2019-10-31 |
| Jonathan Terry Marshall | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2018-10-01 ~ 2019-09-30 |
| Michael Frank Tabone | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2018-02-01 ~ 2019-01-31 |
| Douglas Stephen Drumsta | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2018-02-01 ~ 2019-01-31 |
| Charles James Lesh | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2018-02-01 ~ 2019-01-31 |
| Anthony Robert Mangano | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2017-12-01 ~ 2018-11-30 |
| Phillip Adam Baum | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2017-11-01 ~ 2018-10-31 |
| Andrew Terrell Dunn | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2017-08-01 ~ 2018-07-31 |
| Thomas Anthony Lostracco | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2017-08-01 ~ 2018-07-31 |
| Kenneth Daniel Pearsen | 199 Park Club Lane Suite 300, Williamsville, NY 14221 | Physician/surgeon | 2017-08-01 ~ 2018-07-31 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marc C Mussachio | 30 N Forest Rd, Williamsville, NY 14221 | Architect | 2020-08-01 ~ 2021-07-31 |
| Kathleen A Swann | 2330 Maple Rd, Williamsville, NY 14221 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Asher B Blum | 163 Viscount Dr, Williamsville, NY 14221 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| David R Ludwig | 75 Farmington Road, Williamsville, NY 14221 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Andrew V Terragnoli | 205 Maple Rd, Williamsville, NY 14221 | Professional Engineer | 2020-02-24 ~ 2021-01-31 |
| Adrian A Forzani II | 158 Brushcreek Rd, Williamsville, NY 14221 | Professional Engineer | 2014-02-01 ~ 2015-01-31 |
| Yasser M Heakal | 70 Glendon Pl, Williamsville, NY 14221 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Neiman Funds | 6631 Main Street, Williamsville, NY 14221 | Investment Company - Open End | 2019-12-31 ~ 2020-12-31 |
| Shelina Siu | 84 Sandhurst Ct, Williamsville, NY 14221 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Satish B Mohan · Progressive Builders | 126 Viscount Dr, Williamsville, NY 14221 | Home Improvement Contractor | 2018-09-20 ~ 2019-11-30 |
| Find all Licenses in zip 14221 | |||
| City | Williamsville |
| Zip Code | 14221 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Williamsville |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jason Robert's Inc | 12c Tipping Dr, Branford, CT 06405 | Home Improvement Contractor | 2019-12-10 ~ 2020-11-30 |
| Jason Shapiro | 35 Leicester Way, Pawtucket, RI 02860-5609 | Physician/surgeon | ~ |
| Jason Sperling | 1 Columbia St Ste 300, Poughkeepsie, NY 12601-3924 | Physician/surgeon | ~ |
| Jason C. Chen | 35 River Rd, Cos Cob, CT 06807-2759 | Physician/surgeon | 2012-04-01 ~ 2013-03-31 |
| Jason Deutsch | 285 Lafayette St, New York, NY 10012 | Physician/surgeon | ~ |
| Jason A Remick | 6 Ward Ave, Audubon, NJ 08106-1918 | Physician/surgeon | ~ |
| Jason D Beck | 207 Sunset Dr, Lucedale, MS 39452-3620 | Physician/surgeon | ~ |
| Jason Robert's Services LLC | 54 Bagley Avenue, Hamden, CT 06514 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Jason R Cataldo | 81 Hartford Ave, Old Saybrook, CT 06475-1973 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jason H Dorey | P.o. Box 1663, Opelika, AL 36801 | Physician/surgeon | ~ 1997-05-31 |
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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).