KATIE LYNN ANDERSON (Credential# 1440805) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
KATIE LYNN ANDERSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003930. The credential type is physician assistant. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 15 Wiemes Ct, Waterford, CT 06385. The current status is active.
| Licensee Name | KATIE LYNN ANDERSON |
| Credential ID | 1440805 |
| Credential Number | 23.003930 |
| Credential Type | Physician Assistant |
| Business Address |
15 Wiemes Ct Waterford CT 06385 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-08-17 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1454265 | CSP.0066903 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-10-04 | 2017-10-04 - 2019-02-28 | LAPSED |
| Street Address | 15 Wiemes Ct |
| City | Waterford |
| State | CT |
| Zip Code | 06385 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Howard Christopher Rosas | 40 Ridgewood Ave, Waterford, CT 06385 | Chiropractor | 2020-07-01 ~ 2021-06-30 |
| Vincent F Donato | 26 Wild Rose Avenue, Waterford, CT 06385 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Mark A Herter | 51 Quarry Rd, Waterford, CT 06385 | Architect | 2020-08-01 ~ 2021-07-31 |
| Pamela A Manke | 54 Rope Ferry Rd., Waterford, CT 06385 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Carol Winslow | 18 Myrock Ave, Waterford, CT 06385 | Marital and Family Therapist | 2020-09-01 ~ 2021-08-31 |
| Donna M Rivero · Knupp | 3 Ridgewood Ave, Waterford, CT 06385 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Margaret A Goldschneider · Chapman | 3 High Ridge Drive, Waterford, CT 06385 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Frank R Dellacono Md | 201 Boston Post Road, Waterford, CT 06385 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mathew H Tellier | 25 Locust Ct., Waterford, CT 06385 | Backflow Prevention Device Tester | 2020-06-18 ~ 2023-03-31 |
| Renata Kamburi | 16 Marilyn Road, Waterford, CT 06385 | Esthetician | 2020-06-20 ~ 2021-12-31 |
| Find all Licenses in zip 06385 | |||
| City | Waterford |
| Zip Code | 06385 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + Waterford |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Katie Lynn Tichenor | 2 Ross Passway, Morris, CT 06763-1300 | Physician Assistant | 2016-11-01 ~ 2017-10-31 |
| Katie Lynn Scott | 5717 Pacific Center Blvd, San Diego, CA 92121-4250 | Physician Assistant | 2020-01-01 ~ 2020-12-31 |
| Katie S Kwok Pa-c | 177 Judson Rd, Fairfield, CT 06824 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Katie L Merithew | 10 Phelps Dr, Hamden, CT 06514 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Katie M Roach | 3 David Drive, Simsbury, CT 06070 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Katie J Arey | 9 Cobblestone Dr, Broad Brook, CT 06016-1200 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Katie A Coppola | 288 Haddam Quarter Rd, Durham, CT 06422-1618 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Stacie B Campbell | 646 Anderson Ave., New York, NY 10024 | Physician Assistant | 2005-09-01 ~ 2006-09-30 |
| Bodhi M Anderson | 100 Barenaba Ln, Hilo, HI 96720-4218 | Physician Assistant | 2019-11-01 ~ 2020-10-31 |
| Deanne M Anderson | 154 Croyden Terrace, Springfield, MA 01104 | Physician Assistant | 1999-08-03 ~ 1999-10-31 |
Please comment or provide details below to improve the information on KATIE LYNN ANDERSON.
| 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).