TODD A FORMAN (Credential# 690166) is licensed (Physical Therapist) with Connecticut Department of Consumer Protection. The license effective date is November 24, 1992. The license expiration date date is December 31, 1993. The license status is INACTIVE.
TODD A FORMAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #14.004585. The credential type is physical therapist. The effective date is November 24, 1992. The expiration date is December 31, 1993. The business address is 278 Main St, West Haven, CT 06516. The current status is inactive.
| Licensee Name | TODD A FORMAN |
| Credential ID | 690166 |
| Credential Number | 14.004585 |
| Credential Type | Physical Therapist |
| Business Address |
278 Main St West Haven CT 06516 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1992-09-01 |
| Effective Date | 1992-11-24 |
| Expiration Date | 1993-12-31 |
| Refresh Date | 2009-07-08 |
| Street Address | 278 MAIN ST |
| City | WEST HAVEN |
| State | CT |
| Zip Code | 06516 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marie Goldah Petalcorin Quiblat | 278 Main St, West Haven, CT 06516-4746 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Day Marie Ortiz | 278 Main St, West Haven, CT 06516 | Licensed Practical Nurse | 2020-02-01 ~ 2021-01-31 |
| Randa Johnson | 278 Main St, West Haven, CT 06516-4941 | Real Estate Salesperson | 2019-06-01 ~ 2020-05-31 |
| Barbara A Begnoche | 278 Main St, West Haven, CT 06516 | Hairdresser/cosmetician | 1996-01-22 ~ 1996-10-31 |
| Mary M Powell | 278 Main St, West Haven, CT 06516 | Registered Nurse | 1988-03-23 ~ 1988-09-15 |
| Touch By An Angel Home Care New England LLP | 278 Main St, West Haven, CT 06516-7318 | Homemaker Companion Agency | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nancy Cabrera Salinas | 649 Third Ave., West Haven, CT 06516 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-07-31 |
| Lauralee L Gaglio | 27 Peppermill Drive, West Haven, CT 06516 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Evelyn Ruiz Conant | 309 Terrace Ave, Unit 42, West Haven, CT 06516 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Junqin Wang | 15 Central Ave West Haven, West Haven, CT 06516 | Nail Technician | ~ |
| Mehmet Sofuoglu Md | Va Conn Healthcare System, West Haven, CT 06516 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Monica M Skakacz | 19 Cowpen Rd, West Haven, CT 06516 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Lourdes Maribel Guzman | 26 York Street, West Haven, CT 06516 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Mcdonald's · Tay Mac Dba | 1129 Campbell Ave, West Haven, CT 06516 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Dyaija Soriano | 29 Ridge Court East, West Haven, CT 06516 | Esthetician | 2020-06-26 ~ 2022-05-31 |
| Katherine M Grable | 13 Perry Merrill Drive, West Haven, CT 06516 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06516 | |||
| City | WEST HAVEN |
| Zip Code | 06516 |
| License Type | Physical Therapist |
| License Type + County | Physical Therapist + WEST HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Georgianna Forman Tata | 219 Matthew St, Prospect, CT 06712-1417 | Physical Therapist | 2020-05-01 ~ 2021-04-30 |
| Richard Forman · Forman Vineyard | 1501 Big Rock Rd, Saint Helena, CA 94574-9613 | Out of State Winery | 2015-04-01 ~ 2016-03-31 |
| Todd M Wilkowski | 35 River Rd, Cos Cob, CT 06807-2759 | Physical Therapist | 2020-08-01 ~ 2021-07-31 |
| Todd R Scheer | 19 Coe Ave, Portland, CT 06480-1405 | Physical Therapist | 2020-08-01 ~ 2021-07-31 |
| Todd M Roberts | 2 Wildwood Rd, Old Saybrook, CT 06475-2733 | Physical Therapist | 2015-08-01 ~ 2016-01-20 |
| Sarah Margaret Todd | 9 M, Norwalk, CT 06854 | Physical Therapist | 2019-09-01 ~ 2020-08-31 |
| Todd E Feinkind | 17 Algonquin Dr, Irvington, NY 10533-1007 | Physical Therapist | 2011-05-13 ~ 2012-03-31 |
| Marisa A Santopietro | 325 Todd Rd, Wolcott, CT 06716-2849 | Physical Therapist | 2020-03-01 ~ 2021-02-28 |
| Veronika Todd | 675 Marcy Ave Apt 4f, Brooklyn, NY 11216-1021 | Physical Therapist | 2020-02-27 ~ 2020-10-31 |
| Todd W Cacopardo | 14 Jordan Ln, Portland, CT 06480-1620 | Physical Therapist | 2019-12-01 ~ 2020-11-30 |
Please comment or provide details below to improve the information on TODD A FORMAN.
| 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).