LISA VANTY PA (Credential# 741899) 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.
LISA VANTY PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000150. The credential type is physician assistant. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 69 Toll Gate Road, Berlin, CT 06037. The current status is active.
| Licensee Name | LISA VANTY PA |
| Credential ID | 741899 |
| Credential Number | 23.000150 |
| Credential Type | Physician Assistant |
| Business Address |
69 Toll Gate Road Berlin CT 06037 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1993-10-01 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-05-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 161709 | CSP.0021597 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 69 Toll Gate Road |
| City | BERLIN |
| State | CT |
| Zip Code | 06037 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jolanta Wilinski-pelech | 163 Hillside Rd, Berlin, CT 06037 | Esthetician | ~ |
| Susann A Pavano | 67 Hickory Hill Rd, Kensington, CT 06037 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Marco A Giannone | 101 Grapevine Lane, Berlin, CT 06037 | Real Estate Salesperson | 2020-06-18 ~ 2021-05-31 |
| Linda A Giove | 48 Winding Meadow D, Kensington, CT 06037 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Kevin P Gallagher | 206 Fairview Dr, Berlin, CT 06037 | Embalmer | 2020-07-01 ~ 2021-06-30 |
| Stephanie M Sadlowski | 28 Cynthia Drive, Kensington, CT 06037 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Violet Pastorkova-jaouen | 959 Four Rod Road, Berlin, CT 06037 | Dietitian/nutritionist | 2020-07-01 ~ 2021-06-30 |
| Constantine S Buonanno Dmd | 1105 Farmington Ave, Kensington, CT 06037 | Dentist | 2020-04-01 ~ 2021-03-31 |
| Lisa Divalentino | 23 Garden Drive, Kensington, CT 06037 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| William Dornfried | 240 Kensington Road, Berlin, CT 06037 | Water Treatment Plant Operator - Class I | 2020-04-01 ~ 2023-03-31 |
| Find all Licenses in zip 06037 | |||
| City | BERLIN |
| Zip Code | 06037 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + BERLIN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lisa A. White | 4 Carlton Ln, Hopkinton, RI 02833-1103 | Physician Assistant | 2019-07-01 ~ 2020-06-30 |
| Ann Marie Schoppmann Pa | 11 Lisa Ln, Woodbridge, CT 06525 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Lisa C Perry Pa | 109 Reverknolls, Avon, CT 06001-2038 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Lisa M Collison | 6 Sundon Lane, Old Saybrook, CT 06475 | Physician Assistant | 1999-07-16 ~ 2000-09-30 |
| Lisa E Shakun Pa-c | 5 Dunbar Drive, Windsor, CT 06095 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Lisa Christine Martin | 381 Willow St, Mansfield, MA 02048 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Lisa A Rampone | 3 Purgatory Road, Exeter, RI 02822 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Lisa M Ambrogio-decola | 120 Townsend Ave, New Haven, CT 06512-4045 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Lisa A Rinaldi Pa | 16 Pelham Rd, West Hartford, CT 06107-2718 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Lisa L Belanger Pa | 11 Union Place, Manchester, CT 06040 | Physician Assistant | 2004-07-07 ~ 2005-07-31 |
Please comment or provide details below to improve the information on LISA VANTY 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).