ATHENA RAKEBRAND (Credential# 1668498) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
ATHENA RAKEBRAND is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.004606. The credential type is physician assistant. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 266 Beecher Dr, Southbury, CT 06488-3912. The current status is active.
Licensee Name | ATHENA RAKEBRAND |
Credential ID | 1668498 |
Credential Number | 23.004606 |
Credential Type | Physician Assistant |
Business Address |
266 Beecher Dr Southbury CT 06488-3912 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2019-09-24 |
Effective Date | 2020-04-01 |
Expiration Date | 2021-03-31 |
Refresh Date | 2020-02-05 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1788734 | CSP.0072484 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-09-26 | 2019-09-26 - 2021-02-28 | ACTIVE |
Street Address | 266 BEECHER DR |
City | SOUTHBURY |
State | CT |
Zip Code | 06488-3912 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Jillian Jung | 582 Patriot Rd, Southbury, CT 06488 | Radiographer | 2020-08-01 ~ 2021-07-31 |
Mary E Kohler | 201 Old Highway, Southbury, CT 06488 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Theresa K Bobak | 266b Heritage Village, Southbury, CT 06488 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
Kelly Watson | 800 Main Street South Suite 102, Southbury, CT 06488 | Medication Administration Certification | 2018-06-27 ~ 2020-06-26 |
Mcdonald's Rest #2104 | 44 Division St, Derby, CT 06488 | Bakery | 2020-07-01 ~ 2021-06-30 |
Shirley A Frager | 5 West View Rd, Southbury, CT 06488 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Maureen K Boyd | 77 Shane Drive, Southbury, CT 06488 | Physical Therapist | 2020-09-01 ~ 2021-08-31 |
South Britain Oil LLC | 424 Old Field Rd, Southbury, CT 06488 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Won Ju Lee | 995 Old Field Rd, Southbury, CT 06488 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-01-31 |
Mcdonald's Rest #27001 | 652 New Haven Ave, Derby, CT 06488 | Bakery | 2020-07-01 ~ 2021-06-30 |
Find all Licenses in zip 06488 |
City | SOUTHBURY |
Zip Code | 06488 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + SOUTHBURY |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Athena Home Health LLC · Athena Care At Home | 135 South Rd, Farmington, CT 06032-2556 | Homemaker Companion Agency | 2019-11-15 ~ 2020-10-31 |
Elizabeth Kanakis · Athena II | 320 Washington Avenue, North Haven, CT 06473 | Restaurant Liquor | 2005-10-05 ~ 2006-10-04 |
Athena Neurosciences Inc | 800 F Gateway Blvd, South San Francisco, CA 94080 | Wholesaler of Drugs, Cosmetics & Medical Devices | 1998-07-01 ~ 1999-06-30 |
Athena Foundation | 70 E. Lake Street; Suite 1220, Chicago, IL 60601 | Public Charity | 2005-10-01 ~ 2006-05-31 |
Athena Venture Inc | 5 Webb Rd, Westport, CT 06880-3728 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
Athena Diner | 3350 Post Rd, Southport, CT 06490 | Bakery | 2016-07-01 ~ 2017-06-30 |
Michael J B Gonzalez Md | 21 Athena Terr, Portsmouth, RI 02871 | Physician/surgeon | 2006-02-07 ~ 2007-03-31 |
Konstantina Athena Papathomas | 1945 Lakepointe Dr, Lewisville, TX 75057-6424 | Physician/surgeon | ~ |
Athena M Countouriotis | 38 Goodwin Circle, Hartford, CT 06105 | Physician/surgeon | 2006-09-27 ~ 2007-11-30 |
Athena Medical LLC | 2 Old New Milford Rd, Brookfield, CT 06804-2426 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2018-08-06 ~ 2019-06-30 |
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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).