TRACIE M STOM (Credential# 577091) is licensed (Registered Nurse) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2004. The license expiration date date is January 31, 2005. The license status is INACTIVE.
TRACIE M STOM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #10.073087. The credential type is registered nurse. The effective date is April 1, 2004. The expiration date is January 31, 2005. The business address is 4747 Mountain View Drive, Boise, ID 83704. The current status is inactive.
Licensee Name | TRACIE M STOM |
Credential ID | 577091 |
Credential Number | 10.073087 |
Credential Type | Registered Nurse |
Business Address |
4747 Mountain View Drive Boise ID 83704 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 2004-04-01 |
Effective Date | 2004-04-01 |
Expiration Date | 2005-01-31 |
Refresh Date | 2009-07-08 |
Street Address | 4747 Mountain View Drive |
City | Boise |
State | ID |
Zip Code | 83704 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Riley J Mahaffey | 201 N Maple Grove Rd Ste 100, Boise, ID 83704 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
Debra A Cordon | 4393 North Dalton Lane, Boise, ID 83704 | Registered Nurse | 2009-03-16 ~ 2010-03-31 |
Kevin P Keegan | 8548 Pembrook, Boise, ID 83704 | Emergency Medical Technician | ~ 1992-07-01 |
Melissa M Stanfill | 2296 N Carmen Ave, Boise, ID 83704 | Registered Nurse | 2007-09-20 ~ 2008-10-31 |
Nola Rae Applebee | 1346 N.pilgrim Ave, Boise, ID 83704 | Registered Nurse | 2006-09-18 ~ 2007-09-30 |
Sydnie A Braithwaite | 9148 W. Tudor Court, Boise, ID 83704 | Registered Nurse | 2005-12-01 ~ 2006-12-31 |
Vaughn A Applebee | 1346 N. Pilgrim Ave., Boise, ID 83704 | Registered Nurse | 2006-09-18 ~ 2007-10-31 |
Anna M Aramburu | 7545 Manorwood Drive, Boise, ID 83704 | Dental Hygienist | 2006-06-14 ~ 2007-06-30 |
Catherine M. Hitt-piechowski | 3560 Kilarney Drive, Boise, ID 83704 | Pharmacist | 1999-02-01 ~ 2000-01-31 |
Gary W Groff | 7957 W Bayhill Ct, Boise, ID 83704-0712 | Professional Engineer | 2016-02-01 ~ 2017-01-31 |
Find all Licenses in zip 83704 |
City | Boise |
Zip Code | 83704 |
License Type | Registered Nurse |
License Type + County | Registered Nurse + Boise |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Joan M Petosa · Tracie's Pub | 8 Divinity Street, Bristol, CT 06010 | Cafe Liquor | 2003-12-10 ~ 2004-12-09 |
Tracie Craig | 505 Roode Rd, Griswold, CT 06351-1231 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Tracie L Combs | 221 Jefferson Rd, Boone, NC 28607 | Registered Nurse | 2015-02-02 ~ 2016-02-29 |
Tracie R Oliveri | 93 Mountain Rd, Cheshire, CT 06410-3938 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
Tracie Lacasse | 83 North St, Granby, MA 01033 | Registered Nurse | 2004-08-26 ~ 2005-10-31 |
Tracie A Crisafulli | 239 Old Farms Rd Apt 4a, Avon, CT 06001-2207 | Registered Nurse | 2017-06-01 ~ 2018-05-31 |
Tracie L Fredericksen | 109 Aldbourne Dr, Bristol, CT 06010 | Registered Nurse | 2019-08-01 ~ 2020-07-31 |
Tracie L Banares | 7 Everson Way, Ballston Spa, NY 12020-2237 | Registered Nurse | 2015-04-15 ~ 2016-03-31 |
Tracie Nalley | 80 Stanley St, New Haven, CT 06511-4231 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Tracie Russell | 38 Spring St, Derby, CT 06418-1320 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
Please comment or provide details below to improve the information on TRACIE M STOM.
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).