SAMANTHA FORMICA (Credential# 1658178) is licensed (Speech and Language Pathologist) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is August 31, 2020. The license status is ACTIVE IN RENEWAL.
SAMANTHA FORMICA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #18.006207. The credential type is speech and language pathologist. The effective date is June 1, 2020. The expiration date is August 31, 2020. The business address is 767 Arbutus St, Middletown, CT 06457-5120. The current status is active in renewal.
| Licensee Name | SAMANTHA FORMICA |
| Credential ID | 1658178 |
| Credential Number | 18.006207 |
| Credential Type | Speech and Language Pathologist |
| Business Address |
767 Arbutus St Middletown CT 06457-5120 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE IN RENEWAL - CURRENT |
| Active | 1 |
| Issue Date | 2020-06-01 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2020-08-31 |
| Refresh Date | 2020-06-01 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1674027 | 18.005957-TEMP | Speech and Language Pathologist Temporary Permit | 2019-07-17 | 2019-05-13 - 2020-05-13 | INACTIVE |
| Street Address | 767 ARBUTUS ST |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-5120 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kristin L Formica · Robie | 767 Arbutus St, Middletown, CT 06457 | Dental Hygienist | 2020-06-01 ~ 2021-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jessica Marie Jenkins | 749 Arbutus St, Middletown, CT 06457-5120 | Registered Nurse | 2019-10-17 ~ 2020-10-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth M Mailhot | 177 Timber Ridge Rd, Middletown, CT 06457 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Rebecca S Fennessy | 22 Keefe Ln, Middletown, CT 06457 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Eloise M Gagnon | 538 Bow Lane, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Salvatore Dimauro | 245 Dekoven Dr, Middletown, CT 06457 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Frank L Wright | 261 Spencer Dr, Middletown, CT 06457 | Barber | 2020-08-01 ~ 2022-07-31 |
| Gino A Cardella | 50 Sonoma Lane, Middletown, CT 06457 | Real Estate Salesperson | ~ |
| Shannon Lee Mcquillan | 5 Forest Glen Circle, Middletown, CT 06457 | Registered Nurse | 2020-06-26 ~ 2020-09-30 |
| Lori Dimauro · Carta | 244 Chamberlain Hill Road, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Gail A Corrow | 85 Dora Dr, Middletown, CT 06457 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Mariter V Perez | 8 Moss Glen, Middletown, CT 06457 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06457 | |||
| City | MIDDLETOWN |
| Zip Code | 06457 |
| License Type | Speech and Language Pathologist |
| License Type + County | Speech and Language Pathologist + MIDDLETOWN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Samantha Greco | 4 Gem Dr, Ellington, CT 06029-3906 | Speech and Language Pathologist | ~ |
| Samantha Coulombe | 8 Noor Dr, Coventry, CT 06238-1095 | Speech and Language Pathologist | ~ |
| Samantha E Sapanski | 239 Hulls Hwy, Southport, CT 06890-1137 | Speech and Language Pathologist | 2018-06-01 ~ 2019-05-31 |
| Samantha Capece | 500 Bedford St Apt 207, Stamford, CT 06901-1508 | Speech and Language Pathologist | 2020-06-01 ~ 2021-05-31 |
| Samantha Winkler | 96 Frisbie St, Middletown, CT 06457-4611 | Speech and Language Pathologist | 2019-09-01 ~ 2020-08-31 |
| Samantha Liguori | 133 Farmington Ave, Fairfield, CT 06825-1519 | Speech and Language Pathologist | 2020-03-01 ~ 2021-02-28 |
| Samantha T Fitzsimmons | 234 Plain Hill Rd, Norwich, CT 06360-1667 | Speech and Language Pathologist | 2013-10-01 ~ 2014-09-30 |
| Samantha Ellis Sebastian | 4 Cornelia Dr, Greenwich, CT 06830-3906 | Speech and Language Pathologist | 2019-08-01 ~ 2020-04-30 |
| Samantha Pittman | 587 Vauxhall Street Ext, Waterford, CT 06385-4301 | Speech and Language Pathologist | 2019-09-01 ~ 2020-08-31 |
| Samantha M. Isanberg | 11 Cherry Hill Rd, Fairfield, CT 06825-1005 | Speech and Language Pathologist | 2020-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on SAMANTHA FORMICA.
| 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).