LEANNE M VANDER WALL
Dental Hygienist


Address: 399 Beelzebub Rd, South Windsor, CT 06074

LEANNE M VANDER WALL (Credential# 685051) is licensed (Dental Hygienist) with Connecticut Department of Consumer Protection. The license effective date is May 9, 1994. The license expiration date date is June 30, 1995. The license status is INACTIVE.

Business Overview

LEANNE M VANDER WALL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #13.004917. The credential type is dental hygienist. The effective date is May 9, 1994. The expiration date is June 30, 1995. The business address is 399 Beelzebub Rd, South Windsor, CT 06074. The current status is inactive.

Basic Information

Licensee Name LEANNE M VANDER WALL
Credential ID 685051
Credential Number 13.004917
Credential Type Dental Hygienist
Business Address 399 Beelzebub Rd
South Windsor
CT 06074
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1990-10-13
Effective Date 1994-05-09
Expiration Date 1995-06-30
Refresh Date 2009-07-08

Office Location

Street Address 399 BEELZEBUB RD
City SOUTH WINDSOR
State CT
Zip Code 06074

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Ashley Ann Corridori 21 Abar Lane, South Windsor, CT 06074 Physician Assistant 2020-07-01 ~ 2021-06-30
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Competitor

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City SOUTH WINDSOR
Zip Code 06074
License Type Dental Hygienist
License Type + County Dental Hygienist + SOUTH WINDSOR

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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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