JENNIE PUTNAM PA (Credential# 742233) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 5, 1996. The license expiration date date is March 31, 1997. The license status is INACTIVE.
JENNIE PUTNAM PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000484. The credential type is physician assistant. The effective date is March 5, 1996. The expiration date is March 31, 1997. The business address is 45 Linden Ave, Branford, CT 06405. The current status is inactive.
| Licensee Name | JENNIE PUTNAM PA |
| Credential ID | 742233 |
| Credential Number | 23.000484 |
| Credential Type | Physician Assistant |
| Business Address |
45 Linden Ave Branford CT 06405 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1995-01-20 |
| Effective Date | 1996-03-05 |
| Expiration Date | 1997-03-31 |
| Refresh Date | 2009-07-10 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 162081 | CSP.0023582 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1996-03-01 - 1997-02-28 | INACTIVE |
| Street Address | 45 LINDEN AVE |
| City | BRANFORD |
| State | CT |
| Zip Code | 06405 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Raymond M Johnson | 39 Bayberry Lane, Branford, CT 06405 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kirsten M Ranciato | 288 East Main Street, Branford, CT 06405 | Licensed Clinical Social Worker | 2020-08-01 ~ 2021-07-31 |
| Bimala Khadka Thapa | 726 Robert Frost Dr., Branford, CT 06405 | Nail Technician | ~ |
| Paul E Basile | 42 Valley Brook Road South, Branford, CT 06405 | Perfusionist | 2020-08-01 ~ 2021-07-31 |
| Lupe Monica Placencia-muy | 100 East Main Street 2nd Fl, Branford, CT 06405 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-02-28 |
| Bridget J Jennings | 159 Queach Road, Branford, CT 06405 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Ujeli Acharya | 21 Burban Drive, Branford, CT 06405 | Nail Technician | ~ |
| Cathleen Smith | 50 First Avenue, Branford, CT 06405 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Gita Thapa | 94 Village Lane, Branford, CT 06405 | Nail Technician | ~ |
| Cycle Venture Partners Fund I Lp - Lumeda Series 1 | 50 Limewood Avenue, Branford, CT 06405 | Securities - Exemptions | 2020-06-17 ~ |
| Find all Licenses in zip 06405 | |||
| City | BRANFORD |
| Zip Code | 06405 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + BRANFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jennie Shar | 550 Circular Ave, Hamden, CT 06514 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Christopher Prezzano | 94 Cayuga Rd, Putnam Valley, NY 10579-2106 | Physician Assistant | ~ |
| Tom Warzecka Pa | Day Kimball Hospital, Putnam, CT 06250 | Physician Assistant | 2001-07-16 ~ 2002-07-31 |
| Jason David Williams | 145 Pomfret St, Putnam, CT 06260-1803 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Jennie L Kesselman | 346 Pomfret St, Putnam, CT 06260-1871 | Acupuncturist | 2020-01-01 ~ 2021-12-31 |
| Jennie Eleanor Matays | 21 Putnam Grn Apt C, Greenwich, CT 06830-6044 | Registered Nurse | 2018-04-25 ~ 2018-08-31 |
| Jennie A Day | 468 Cotton Hill Rd, New Hartford, CT 06057-3403 | Physical Therapist Assistant | 2020-01-01 ~ 2020-12-31 |
| Jennie Moody | 5 Cherry St, Pawcatuck, CT 06379 | Family Child Care Assistant | 1996-11-30 ~ 1996-11-30 |
| Jennie's Pizza · Jennie's Pizzeria Inc | 380 Monroe Tpke, Monroe, CT 06468 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Jennie Taylor | 129 Elmwood Place, Bridgeport, CT 06605 | Family Child Care Assistant | 1999-01-31 ~ 1999-01-31 |
Please comment or provide details below to improve the information on JENNIE PUTNAM 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).