SUSAN FAIR PA (Credential# 741831) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
SUSAN FAIR PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000082. The credential type is physician assistant. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 24 Woodward Ave #61, New Haven, CT 06512-3636. The current status is active.
| Licensee Name | SUSAN FAIR PA |
| Credential ID | 741831 |
| Credential Number | 23.000082 |
| Credential Type | Physician Assistant |
| Business Address |
24 Woodward Ave #61 New Haven CT 06512-3636 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1993-08-13 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-04-20 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 164257 | CSP.0021392 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 24 WOODWARD AVE #61 |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06512-3636 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Yong Roch | 24 Woodward Ave Apt 51, New Haven, CT 06512-3636 | Hairdresser/cosmetician | 2016-12-01 ~ 2018-11-30 |
| Ceferino Rodriguez | 24 Woodward Ave Apt 54, New Haven, CT 06512-3636 | Heating, Piping & Cooling Unlimited Journeyperson | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| East Haven Police Union Local #1662 | Po Box 120033, East Haven, CT 06512 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Danielle M Verderame | 66 Maple Street, East Haven, CT 06512 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Judith M Lyon · Sousa | 440 Townsend Ave, New Haven, CT 06512 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Toni Louise Montuori | 44 Francis St, East Haven, CT 06512 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Marcos E Zambrano | 17 Morse Place, New Haven, CT 06512 | Real Estate Salesperson | ~ |
| Nha H Lam | 274 Chidsey Ave, East Haven, CT 06512 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2021-07-31 |
| Niraliben N Patel | 44 Columbus Ave, East Haven, CT 06512 | Esthetician | ~ |
| Alyssa C Zordan | 65 Francis Street, East Haven, CT 06512 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Gomes Cleaning & Painting LLC | 296 Burr St, New Haven, CT 06512 | Home Improvement Contractor | 2020-06-18 ~ 2020-11-30 |
| Keith Bouve · Residential Restorations | 99 Prospect Rd, East Haven, CT 06512 | Home Improvement Contractor | 2020-06-24 ~ 2020-11-30 |
| Find all Licenses in zip 06512 | |||
| City | NEW HAVEN |
| Zip Code | 06512 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Matthew D Nankin | 138 Fair St, Wallingford, CT 06492-4210 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Lyncy Simon | 110 Fair Street, Carmel, NY 10512 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Susan Martins Pa | 66 Susan Dr, Ludlow, MA 01056 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Chetna Patel | 29 Susan Dr, Dudley, MA 01571-3800 | Physician Assistant | ~ |
| Susan K Peters-pac | 216 Oxford St, Hartford, CT 06105-2250 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Susan Sarvay Pa | 58 Neal St Apt 2, Portland, ME 04102-3561 | Physician Assistant | 2017-06-01 ~ 2018-05-31 |
| Susan L Epperson | 40 Greenbriar Mnr, Campbellsville, KY 42718 | Physician Assistant | ~ 1997-10-31 |
| Susan Curilla | 9 E Tomstead Rd, Simsbury, CT 06070-2005 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Susan M Roy | 2086 Stanley St #408, New Britain, CT 06053 | Physician Assistant | 1994-01-10 ~ 1995-01-31 |
| Susan L Rancis | 5 Raphael Way, Westport, CT 06880 | Physician Assistant | 1997-07-29 ~ 1998-07-31 |
Please comment or provide details below to improve the information on SUSAN FAIR PA.
| 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).