DANIEL D FOTTRELL PA-C (Credential# 473124) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
DANIEL D FOTTRELL PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0041589. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 21 Maine Rd, Patterson, NY 12563-1443. The current status is active.
| Licensee Name | DANIEL D FOTTRELL PA-C |
| Credential ID | 473124 |
| Credential Number | CSP.0041589 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
21 Maine Rd Patterson NY 12563-1443 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2007-06-08 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 743495 | 23.001746 | Physician Assistant | 2005-12-19 | 2019-09-01 - 2020-08-31 | ACTIVE |
| 878555 | 72.000347 | Paramedic | 1997-10-01 | 2013-09-01 - 2014-08-31 | INACTIVE |
| 865787 | 70.940006 | Emergency Medical Technician | 1993-11-29 | - 1994-09-30 | INACTIVE |
| Street Address | 21 MAINE RD |
| City | PATTERSON |
| State | NY |
| Zip Code | 12563-1443 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alexi Renee Palmieri | 11 Danand Lane, Patterson, NY 12563 | Master's Level Social Worker | 2020-08-01 ~ 2021-07-31 |
| Tara M Hartigan | 4 Toronto Road, Patterson, NY 12563 | Notary Public Appointment | 2018-12-11 ~ 2023-12-31 |
| Melisa S Chang | 2891 Route 22, Patterson, NY 12563 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| William C Gronke | 32 Hazel Drive, Patterson, NY 12563 | Respiratory Care Practitioner | 2020-07-01 ~ 2021-06-30 |
| Victoria M. Roark | 17 Veterans Road, Patterson, NY 12563 | Massage Therapist | 2020-08-01 ~ 2022-07-31 |
| Harry A Gonzalez | 22 Weston Place, Patterson, NY 12563 | Emergency Medical Technician | ~ |
| Edward Judy | 268 Mooney Hill Road, Patterson, NY 12563 | Professional Counselor | 2020-07-01 ~ 2021-06-30 |
| Linda J Cochrane | 146 Mountainview Road, Patterson, NY 12563 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Anita M Ostrowska | 49 Baldwin Rd, Patterson, NY 12563 | Real Estate Salesperson | 2017-06-01 ~ 2018-05-31 |
| Denisa Zubkova | 46 Nosh Kola Lane, Patterson, NY 12563 | Real Estate Salesperson | 2017-08-02 ~ 2018-05-31 |
| Find all Licenses in zip 12563 | |||
| City | PATTERSON |
| Zip Code | 12563 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PATTERSON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nicholas P Pietris | 2268 Daniel Island Drive, Daniel Island, SC 29492 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Daniel Southern Md | Daniel Owen Smith Southern, M.d., Wilton, CT 06897 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Daniel G Kramer | Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Daniel Morgensztern | Fmp 121, New Haven, CT 06510-8028 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Daniel K Woo | 100 Jefferson Sq 6h, Waterbury, CT 06706 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Daniel Lim | 111 Park St Apt 8e, New Haven, CT 06511-5455 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Daniel J Degala | 99 Arbor Dr, Ho Ho Kus, NJ 07423-1647 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Daniel J Leonard Iv | 826 Elm St, New Haven, CT 06511-4010 | Controlled Substance Registration for Practitioner | 2011-07-12 ~ 2013-02-28 |
| Daniel S Husted | 22 Ark Rd, Branford, CT 06405 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Daniel M Mclennon Dds | Po Box 327, Coventry, CT 06238-0327 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
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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).