ELLEN E SHATZKIN
Physician Assistant


Address: 53 Beverly Road, White Plains, NY 10605

ELLEN E SHATZKIN (Credential# 742523) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2018. The license expiration date date is February 28, 2019. The license status is INACTIVE.

Business Overview

ELLEN E SHATZKIN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000774. The credential type is physician assistant. The effective date is March 1, 2018. The expiration date is February 28, 2019. The business address is 53 Beverly Road, White Plains, NY 10605. The current status is inactive.

Basic Information

Licensee Name ELLEN E SHATZKIN
Credential ID 742523
Credential Number 23.000774
Credential Type Physician Assistant
Business Address 53 Beverly Road
White Plains
NY 10605
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1998-10-16
Effective Date 2018-03-01
Expiration Date 2019-02-28
Refresh Date 2019-06-03

Office Location

Street Address 53 BEVERLY ROAD
City WHITE PLAINS
State NY
Zip Code 10605

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City WHITE PLAINS
Zip Code 10605
License Type Physician Assistant
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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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