JERRY A BENJAMIN (Credential# 741818) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
JERRY A BENJAMIN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000069. The credential type is physician assistant. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 54 Warwick St, West Hartford, CT 06119. The current status is active.
| Licensee Name | JERRY A BENJAMIN |
| Credential ID | 741818 |
| Credential Number | 23.000069 |
| Credential Type | Physician Assistant |
| Business Address |
54 Warwick St West Hartford CT 06119 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1993-07-30 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-01-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 335567 | CSP.0033406 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2003-04-10 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 49361 | CSP.0025078 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2002-03-01 - 2003-02-28 | INACTIVE |
| Street Address | 54 WARWICK ST |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06119 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Karen K Benjamin | 54 Warwick St, West Hartford, CT 06119 | Licensed Clinical Social Worker | 2020-04-01 ~ 2021-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Danna Rae France | 1148 Boulevard, West Hartford, CT 06119 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-10-31 |
| Rayda R Bouma | 122 Richard St, West Hartford, CT 06119 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Norbert M Spencer | 17 Oakwood Ave., West Hartford, CT 06119 | Professional Counselor | 2020-07-01 ~ 2021-06-30 |
| Diedra A Dietter | 9 Birch Road, West Hartford, CT 06119 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Dahlia I Belnavis-bigenho · Belnavis | 186 Whiting Lane, West Hartford, CT 06119 | Respiratory Care Practitioner | 2020-08-01 ~ 2021-07-31 |
| Stephen R Dewey | 68 Richard St, W Hartford, CT 06119 | Architect | 2020-08-01 ~ 2021-07-31 |
| James E Vance Jr | 9 Plymouth Rd, W Hartford, CT 06119 | Architect | 2020-08-01 ~ 2021-07-31 |
| Mark D Hirsch | 105 Griswold Dr, W Hartford, CT 06119 | Architect | 2020-08-01 ~ 2021-07-31 |
| Judith Briggs | 29 Troy St, West Hartford, CT 06119 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Thulan P Vu | 74 Park Road, West Hartford, CT 06119 | Nail Technician | 2020-06-24 ~ 2022-06-30 |
| Find all Licenses in zip 06119 | |||
| City | WEST HARTFORD |
| Zip Code | 06119 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + WEST HARTFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Benjamin T Houston | 69 Oakleaf Dr, Waterbury, CT 06708-3632 | Physician Assistant | 2016-12-01 ~ 2017-11-30 |
| Benjamin T Gilbert | 290 N Hudson Ave Apt 308e, Pasadena, CA 91101-4429 | Physician Assistant | 2017-11-01 ~ 2018-10-31 |
| Benjamin A Wetstone | 26 Calvin Rd, West Hartford, CT 06110-2110 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Benjamin W Dodson | 552 Wallingford Road, Lancaster, PA 17601 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Marc Benjamin | 40 Glen Hollow, West Hartford, CT 06117-2224 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Benjamin Michael Marks | 250 Victory Hwy., North Smithfield, RI 02896 | Physician Assistant | 2018-02-14 ~ 2018-10-31 |
| Jerry G Huston | 301 S. May St., Joliet, IL 60436 | Physical Therapist Assistant | 2003-01-29 ~ 2006-11-01 |
| Physician Assistant Foundation of The American Academy of Physician Assistants | 2318 Mill Rd Ste 1300, Alexandria, VA 22314-6868 | Public Charity | 2019-12-01 ~ 2020-11-30 |
| Jerry Dexter | 109 Kohanza St Apt 71g, Danbury, CT 06811 | Home Improvement Contractor | ~ 1995-06-01 |
| Jerry R Dame Jr | 7 Baseview Ct, Uncasville, CT 06382 | Home Improvement Contractor | ~ 1995-06-01 |
Please comment or provide details below to improve the information on JERRY A BENJAMIN.
| 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).