ALEXANDER J EJZAK PA (Credential# 509365) 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.
ALEXANDER J EJZAK PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0044022. 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 19 Grandview Farm Dr, Pawcatuck, CT 06379-1287. The current status is active.
| Licensee Name | ALEXANDER J EJZAK PA |
| Credential ID | 509365 |
| Credential Number | CSP.0044022 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
19 Grandview Farm Dr Pawcatuck CT 06379-1287 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2008-08-14 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 743879 | 23.002130 | Physician Assistant | 2008-08-12 | 2019-09-01 - 2020-08-31 | ACTIVE |
| 843452 | 70.003719 | Emergency Medical Technician | 2003-07-10 | 2005-06-15 - 2007-03-31 | INACTIVE |
| Street Address | 19 GRANDVIEW FARM DR |
| City | PAWCATUCK |
| State | CT |
| Zip Code | 06379-1287 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Vinessa Job | 45 Aimee Dr, Pawcatuck, CT 06379 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Rosanne M Giuliano | 25 Davis Avenue, Pawcatuck, CT 06379 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Mary Kathleen Lettich | 15 Canterbury Lane, Stonington, CT 06379 | Behavior Analyst | ~ |
| Deanna L. Boileau-gilman | 37 William Street, Pawcatuck, CT 06379 | Massage Therapist | 2020-08-01 ~ 2022-07-31 |
| Stuart A Lamb | 40 Lester Ave., Pawcatuck, CT 06379 | Optician | 2020-09-01 ~ 2021-08-31 |
| Lisa S Dittman · Boyd | 302 N Anguilla Rd, Pawcatuck, CT 06379 | Physical Therapist | 2020-07-01 ~ 2021-06-30 |
| Naomi Gobeille | 2 North Broad Street, Pawcatuck, CT 06379 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Sherrie L Theroux | 7 Pond View Ct, Pawcatuck, CT 06379 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Robin R Dana | 17 Wilcox Manor, Pawcatuck, CT 06379 | Professional Counselor | 2020-09-01 ~ 2021-08-31 |
| Sharon Marquis | 20 West Enterprise, Pawcatuck, CT 06379 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Find all Licenses in zip 06379 | |||
| City | PAWCATUCK |
| Zip Code | 06379 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PAWCATUCK |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alexander C Ho | 34 Maple St, Norwalk, CT 06850-3815 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Alexander Mahendran | Po Box 187, Thompson, CT 06277-0187 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Alexander F Phan | 25 Palmetto Dr Apt F, Alhambra, CA 91801-5906 | Controlled Substance Registration for Practitioner | 2013-08-16 ~ 2015-02-28 |
| Alexander J Alvarez | 73 Waterbury Rd, Prospect, CT 06712-1252 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Alexander Robertson | 46 Wolcott, Litchfield, CT 06759 | Controlled Substance Registration for Practitioner | 1998-03-01 ~ 1999-02-28 |
| Alexander Ryzhikov | 152 Temple St Apt 107, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Jonathan Alexander | 111 Osborne St Ste 131, Danbury, CT 06810-6019 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Alexander L Johnson | 257 W 97th St, New York, NY 10025-6219 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Jamilah A. Alexander Pa | 17 Oconnor Ave., Holyoke, MA 01040 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| W Alexander Herbordt Md | 30 Orchard Rd, Woodbridge, CT 06525 | Controlled Substance Registration for Practitioner | 1993-09-22 ~ 1995-10-01 |
Please comment or provide details below to improve the information on ALEXANDER J EJZAK PA.
| 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).