MICHAEL B BAUTISTA (Credential# 742371) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is February 1, 2013. The license expiration date date is January 31, 2014. The license status is INACTIVE.
MICHAEL B BAUTISTA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000622. The credential type is physician assistant. The effective date is February 1, 2013. The expiration date is January 31, 2014. The business address is 235 Walton Street, West Hempstead, NY 11552. The current status is inactive.
| Licensee Name | MICHAEL B BAUTISTA |
| Credential ID | 742371 |
| Credential Number | 23.000622 |
| Credential Type | Physician Assistant |
| Business Address |
235 Walton Street West Hempstead NY 11552 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1997-01-17 |
| Effective Date | 2013-02-01 |
| Expiration Date | 2014-01-31 |
| Refresh Date | 2014-05-09 |
| Street Address | 235 Walton Street |
| City | West Hempstead |
| State | NY |
| Zip Code | 11552 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Evangeline S Molina | 235 Walton Street, West Hempstead, NY 11552 | Registered Nurse | 2017-06-01 ~ 2018-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marie I Gracia-pierre | 240 Guildford Court, West Hempstead, NY 11552 | Master's Level Social Worker | 2020-05-01 ~ 2021-04-30 |
| Roger E Ravix | 655 Nightingale Road, West Hempstead, NY 11552 | Licensed Practical Nurse | 2020-01-01 ~ 2020-12-31 |
| Keri Mc Namara | 125 Hempstead Gardens Drive M2d, West Hempstead, NY 11552 | Notary Public Appointment | 2016-06-29 ~ 2021-06-30 |
| Tamir Aldad | 510 Hempstead Tpk, West Hempstead, NY 11552 | Physician/surgeon | 2019-09-03 ~ 2020-09-30 |
| Chiemika Alozie | 956 Derrick Adkins Lane, West Hempstead, NY 11552 | Master's Level Social Worker | 2019-09-01 ~ 2020-08-31 |
| Eliezer Halpert | 256 Windsor Ln, West Hempsted, NY 11552 | Controlled Substance Registration for Practitioner | 2019-02-15 ~ 2021-02-28 |
| Rose Laure Valme | 354 Hempstead Ave, West Hempstead, NY 11552 | Registered Nurse | 2018-02-16 ~ 2018-07-31 |
| Nick Associated Inc | 88 Mayfair Ave, West Hempstead, NY 11552 | Home Improvement Contractor | 2000-12-01 ~ 2001-11-30 |
| Wholesale Remodelers Inc | 333 Hempstead Tpke, West Hempstead, NY 11552 | Home Improvement Contractor | 2000-12-19 ~ 2001-11-30 |
| Sol Niego | 600 Hempstead Tnpk, W Hempstead, NY 11552 | Architect | 2015-08-01 ~ 2016-07-31 |
| Find all Licenses in zip 11552 | |||
| City | West Hempstead |
| Zip Code | 11552 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + West Hempstead |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rebecca Serrano Bautista | 22 Woodberry Court, Wolcott, CT 06716 | Physical Therapist Assistant | ~ |
| Michael Moi | 85 Riverside Ave Apt G2, Stamford, CT 06905-4421 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Emmanuel E Bautista Md | 12 Old Castle Hill Rd, Newtown, CT 06470 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Michael J Hann | 295 E Village Rd, Monroe, CT 06468-3000 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Michael Leonard Rubalsky | 76 Harold Dr, Newington, CT 06111-4220 | Physician Assistant | ~ |
| Michael Dow Pa | 23 Daniel St, East Hampton, CT 06424 | Physician Assistant | 2007-05-18 ~ 2008-07-31 |
| Kyle Michael Schilling | 331 Merrow Rd, Tolland, CT 06084-3935 | Physician Assistant | ~ |
| Carl L Michael | 25 Lefferts Ave., Brooklyn, NY 11225 | Physician Assistant | 2000-06-15 ~ 2000-11-30 |
| Michael J Nolan Pa | 387 Crestwood Dr, Cheshire, CT 06410 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Michael F Iozzo Pa | 17 Crane Rd, Ellington, CT 06029-2004 | Physician Assistant | 2010-09-01 ~ 2011-08-31 |
Please comment or provide details below to improve the information on MICHAEL B BAUTISTA.
| 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).