TRACIE M STOM
Registered Nurse


Address: 4747 Mountain View Drive, Boise, ID 83704

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.

Business Overview

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.

Basic Information

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

Office Location

Street Address 4747 Mountain View Drive
City Boise
State ID
Zip Code 83704

Licenses in the same zip code

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

Competitor

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City Boise
Zip Code 83704
License Type Registered Nurse
License Type + County Registered Nurse + Boise

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Tracie A Crisafulli 239 Old Farms Rd Apt 4a, Avon, CT 06001-2207 Registered Nurse 2017-06-01 ~ 2018-05-31
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Dataset Information

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).

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