COURTNEY ELIZABETH PECK (Credential# 1402313) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
COURTNEY ELIZABETH PECK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003960. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 365 Montauk Ave, New London, CT 06320-4700. The current status is active.
| Licensee Name | COURTNEY ELIZABETH PECK |
| Credential ID | 1402313 |
| Credential Number | 23.003960 |
| Credential Type | Physician Assistant |
| Business Address |
365 Montauk Ave New London CT 06320-4700 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-09-15 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-04-07 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1464091 | CSP.0067175 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-12-04 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 365 MONTAUK AVE |
| City | NEW LONDON |
| State | CT |
| Zip Code | 06320-4700 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Timothy Y Tran | 365 Montauk Ave, New London, CT 06320-4700 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| David F Reisfeld | 365 Montauk Ave, New London, CT 06320 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Nicholas Wyatt Miller | 365 Montauk Ave, New London, CT 06320-4700 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Prakash Kandel | 365 Montauk Ave, New London, CT 06320-4700 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Susan Collemer | 365 Montauk Ave, New London, CT 06320 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Raymond Mark Villalobos | 365 Montauk Ave, New London, CT 06320-4700 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Seth P Dubin, Pa | 365 Montauk Ave, New London, CT 06320-4700 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Lawrence + Memorial Hospital | 365 Montauk Ave, New London, CT 06320-4700 | General Hospital | 2019-04-01 ~ 2021-03-31 |
| Neil Panchal | 365 Montauk Ave, New London, CT 06320-4700 | Controlled Substance Registration for Practitioner | 2020-03-09 ~ 2021-02-28 |
| Mina Masry | 365 Montauk Ave, New London, CT 06320-4700 | Controlled Substance Registration for Practitioner | 2020-02-25 ~ 2021-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paul R Bourguignon | Nemg, New London, CT 06320 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Stephan Nousiopoulos | 27 Alger Place, New London, CT 06320 | Architect | 2020-08-01 ~ 2021-07-31 |
| Diana Elisabeth Cabrera-mora | 327 Montauk Avenue, New London, CT 06320 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-03-31 |
| Yuhua Han | 18 Anthony Rd Apt H, New London, CT 06320 | Massage Therapist | ~ |
| Empire Pizza · Empire Pizza LLC | 150 Broad St, New London, CT 06320 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Irene C Besser | 19 Hawthorne Dr, New London, CT 06320 | Licensed Nurse Midwife | 2020-09-01 ~ 2021-08-31 |
| Robert F Gardner | 241 Crystal Ave, New London, CT 06320 | Home Improvement Salesperson | 2020-06-26 ~ 2020-11-30 |
| Angie Alejandra Botero Castro | 14 Concord Court, Groton, CT 06320 | Master's Level Social Worker | ~ |
| Kevin J O'reilly | 20 Parkway South, New London, CT 06320 | Psychologist | 2020-09-01 ~ 2021-08-31 |
| Sonny's Market LLC | 324 Jefferson Ave, New London, CT 06320 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06320 | |||
| City | NEW LONDON |
| Zip Code | 06320 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + NEW LONDON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Courtney Nicole Enos | 916 1/2 4th St Ne, Byron, MN 55920-1530 | Physician Assistant | ~ |
| Courtney Sherman | 18 John Ct., Randolph, NJ 07869 | Physician Assistant | 2004-01-28 ~ 2004-09-30 |
| Courtney Adair Chenault | 110 Lismore Ave, Glenside, PA 19038-4011 | Physician Assistant | ~ |
| Courtney Christine Marquardt | 1 Dicardee Dr, Enfield, CT 06082-1905 | Physician Assistant | ~ |
| Courtney R Whittle | 73 Perry Rd, Bristol, CT 06010-7812 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Courtney R Hollingsworth | 428 Country Walk, Amherst, OH 44001-2635 | Physician Assistant | 2016-10-01 ~ 2017-09-30 |
| Courtney Wagner Peerless | 52 Charlesgate E Apt 155, Boston, MA 02215-3624 | Physician Assistant | 2018-12-01 ~ 2019-11-30 |
| Heidi A Courtney | 108 Circle Drive, Chicopee, MA 01020 | Physician Assistant | 1999-10-28 ~ 2000-07-31 |
| Janelle K Pacini Pa | 105 Peck Lane, Cheshire, CT 06410 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Courtney M Fankhanel Pa | 10 Twin Pines Drive, Wallingford, CT 06492 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
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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).