SEAN ERVIN LISK (Credential# 1410447) 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.
SEAN ERVIN LISK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003811. The credential type is physician assistant. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 191 Spring St, South Salem, NY 10590-1615. The current status is active.
| Licensee Name | SEAN ERVIN LISK |
| Credential ID | 1410447 |
| Credential Number | 23.003811 |
| Credential Type | Physician Assistant |
| Business Address |
191 Spring St South Salem NY 10590-1615 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-04-06 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-02-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1453777 | CSP.0066893 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-10-03 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 191 SPRING ST |
| City | SOUTH SALEM |
| State | NY |
| Zip Code | 10590-1615 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alice B Gottlieb | 51 Twin Lakes Rd, South Salem, NY 10590 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Lorraine M Gengo | 65 Grandview Road, South Salem, NY 10590 | Massage Therapist | 2020-06-01 ~ 2022-05-31 |
| Jon C Jensen | 11 Elmwood Rd, South Salem, NY 10590 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Ann Marie Sementilli | 14 East Street, South Salem, NY 10590 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Louis M Galasso | 162 Journeys End Rd, South Salem, NY 10590 | Real Estate Salesperson | 2019-06-01 ~ 2020-05-31 |
| Bozena Piechota | 4 Rainbow Hill Road, South Salem, NY 10590 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Jane H Wakeman | 457 Smith Ridge Rd., South Salem, NY 10590 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Mark A Caviola | 14 North Lake Circle, South Salem, NY 10590 | Sub-surface Sewage Installer | 2020-08-01 ~ 2021-07-31 |
| Ann M Nolan | 171journey's End Road, South Salem, NY 10590 | Physical Therapist | 2020-07-01 ~ 2021-06-30 |
| Denise T Mackin | 2 Country Lane, South Salem, NY 10590 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Find all Licenses in zip 10590 | |||
| City | SOUTH SALEM |
| Zip Code | 10590 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + SOUTH SALEM |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sean A Lynch Pa-c | 160 Ardmore St, Hamden, CT 06517 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Sean Edward Hoffman | 311 E Main St, Westfield, MA 01085-3307 | Physician Assistant | 2020-05-01 ~ 2021-05-31 |
| Sean Phillips | 307 State Route 187, Milan, TN 38358-6253 | Physician Assistant | 2019-06-01 ~ 2020-05-31 |
| Sean M. Mcgovern | 32 Grace Lane, Portland, CT 06480 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Sean A Miner Pa | 314 Fern St, West Hartford, CT 06119 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Sean P Dunn | 7030 Los Arboles Ave, Atascadero, CA 93422-4100 | Physician Assistant | 2018-07-01 ~ 2019-06-30 |
| Sean Bennett Eden | 184 Shannock Rd, South Kingstown, RI 02879-4709 | Physician Assistant | 2020-09-01 ~ 2021-08-31 |
| Deborah Lisk Buckingham | 400 Northwood Dr, Centre, AL 35960-1023 | Physician/surgeon | 2019-07-02 ~ 2020-07-31 |
| Linda J Ervin · Ervin | 48 Silkey Road, North Granby, CT 06060 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Pablo Ervin Velazquez | 339 Eastern St Apt B807, New Haven, CT 06513-2437 | Family Child Care Assistant | 2016-04-28 ~ 2018-04-30 |
Please comment or provide details below to improve the information on SEAN ERVIN LISK.
| 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).