PAULA JEANE WILSON
Physician Assistant


Address: 359 Vine Rd, Stamford, CT 06905-2110

PAULA JEANE WILSON (Credential# 1399989) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.

Business Overview

PAULA JEANE WILSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003810. The credential type is physician assistant. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 359 Vine Rd, Stamford, CT 06905-2110. The current status is active.

Basic Information

Licensee Name PAULA JEANE WILSON
Credential ID 1399989
Credential Number 23.003810
Credential Type Physician Assistant
Business Address 359 Vine Rd
Stamford
CT 06905-2110
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2017-04-05
Effective Date 2020-03-01
Expiration Date 2021-02-28
Refresh Date 2020-02-19

Other licenses

ID Credential Code Credential Type Issue Term Status
1417802 CSP.0065201 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2017-04-13 2019-03-01 - 2021-02-28 ACTIVE

Office Location

Street Address 359 VINE RD
City STAMFORD
State CT
Zip Code 06905-2110

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Competitor

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City STAMFORD
Zip Code 06905
License Type Physician Assistant
License Type + County Physician Assistant + STAMFORD

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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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