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.
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.
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 |
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 |
Street Address | 33 NORTH MARK DRIVE |
City | OXFORD |
State | CT |
Zip Code | 06478 |
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 |
Find all Licenses in zip 06478 |
City | OXFORD |
Zip Code | 06478 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + OXFORD |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
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 M Roy | 2086 Stanley St #408, New Britain, CT 06053 | Physician Assistant | 1994-01-10 ~ 1995-01-31 |
Susan Fair Pa | 24 Woodward Ave #61, New Haven, CT 06512-3636 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
Susan Barksdale Pa | 31 Seymour St Ste 100, Hartford, CT 06106-5521 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
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 L Rancis | 5 Raphael Way, Westport, CT 06880 | Physician Assistant | 1997-07-29 ~ 1998-07-31 |
Susan Curilla | 9 E Tomstead Rd, Simsbury, CT 06070-2005 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
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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).