SUSAN ST JACQUES PA
MAIDEN NAME-WIEGERT


Address: 33 North Mark Drive, Oxford, CT 06478

SUSAN ST JACQUES PA (Credential# 742194) 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.

Business Overview

SUSAN ST JACQUES PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000445. The credential type is physician assistant. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 33 North Mark Drive, Oxford, CT 06478. The current status is active.

Basic Information

Licensee Name SUSAN ST JACQUES PA
Doing Business As MAIDEN NAME-WIEGERT
Credential ID 742194
Credential Number 23.000445
Credential Type Physician Assistant
Business Address 33 North Mark Drive
Oxford
CT 06478
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 1994-04-29
Effective Date 2020-05-01
Expiration Date 2021-04-30
Refresh Date 2020-03-09

Other licenses

ID Credential Code Credential Type Issue Term Status
164304 CSP.0022269 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 1999-03-01 2019-03-01 - 2021-02-28 ACTIVE

Office Location

Street Address 33 NORTH MARK DRIVE
City OXFORD
State CT
Zip Code 06478

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Robin M Michalak 5 Macintosh Drive, Oxford, CT 06478 Registered Nurse 2020-08-01 ~ 2021-07-31
Robin M Ambrosio 3 Lolly Lane, Oxford, CT 06478 Licensed Practical Nurse 2020-07-01 ~ 2021-06-30
Hoon Jeon 312 Oxford Rd, Oxford, CT 06478 Combination Nail Technician, Esthetician Or Eyelash Technici 2020-06-26 ~ 2022-01-31
Jacqueline R Sanz Pa 221 Goodhill Rd, Oxford, CT 06478 Dietitian/nutritionist 2020-09-01 ~ 2021-08-31
Sharon A Ritton-holly · Mcgowan 5 Evergreen Lane, Oxford, CT 06478 Radiographer 2020-07-01 ~ 2021-06-30
Anna B Valko 6 Jem Woods Road, Oxford, CT 06478 Notary Public Appointment 2020-09-01 ~ 2025-08-31
Southbury Baking Company LLC 83 Prokop Road, Oxford, CT 06478 Bakery 2020-07-01 ~ 2021-06-30
Leanne C Hovhannissian 25 Belinsky Circle, Oxford, CT 06478 Registered Nurse 2020-07-01 ~ 2021-06-30
Andy Petitti 5 Benson Road, Oxford, CT 06478 Cross Connection Survey Inspector 2020-04-01 ~ 2023-03-31
Lynn Ann Wilkison 6 Silano Drive, Oxford, CT 06478 Notary Public Appointment 2020-06-01 ~ 2025-05-31
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Competitor

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City OXFORD
Zip Code 06478
License Type Physician Assistant
License Type + County Physician Assistant + OXFORD

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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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