PATSY A GERCKENS PA (Credential# 742540) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
PATSY A GERCKENS PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000791. The credential type is physician assistant. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 374 Hawthorne Ave, Derby, CT 06418-1047. The current status is active.
| Licensee Name | PATSY A GERCKENS PA |
| Credential ID | 742540 |
| Credential Number | 23.000791 |
| Credential Type | Physician Assistant |
| Business Address |
374 Hawthorne Ave Derby CT 06418-1047 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1998-12-18 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-02-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 210782 | CSP.0028091 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-04-13 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 1033967 | BNGO.054817-PIN | BINGO OPERATOR | 2011-09-15 - | ACTIVE |
| Street Address | 374 HAWTHORNE AVE |
| City | DERBY |
| State | CT |
| Zip Code | 06418-1047 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Friend's Masonry LLC | 392 Hawthorne Ave, Derby, CT 06418-1047 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| John J Skowronski | 386 Hawthorne Ave, Derby, CT 06418-1047 | Pharmacist | 2016-02-17 ~ 2018-01-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Debra A Montini | 8 Academy Hill Ext, Derby, CT 06418 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Laura M Boanno | 131 Marshall La, Derby, CT 06418 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Danyun Chen | 49 Pershing Dr., Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Fan Geng | Shoprite Shopping Center, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Danni Xu | Shoprite Shopping Center49 Pershing Dr, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Yao Zhang | Shoprite Shopping Center 49 Pershing Dr, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Phillip N Burke | 3 Camptown St, Derby, CT 06418 | Emergency Medical Technician | 2017-06-07 ~ 2020-06-30 |
| Diane A Rosner | 229 Shagbark Drive, Derby, CT 06418 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Pamela C Lavelle | 194 Minerva St, Derby, CT 06418 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Grade A Market - Derby LLC | 49 Pershing Dr, Derby, CT 06418 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06418 | |||
| City | DERBY |
| Zip Code | 06418 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + DERBY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patsy John Carta · Patsy's Cafe | 700 Canal Street, Stamford, CT 06902 | Restaurant Liquor | 2006-09-14 ~ 2007-09-13 |
| Patsy's Market | 398 Center St, Meriden, CT 06450 | Non Legend Drug Permit | ~ 1995-12-31 |
| Patsy Mcguire | 10 Stedman St, Jamaica Plain, MA 02130-3618 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Lovely Patsy Limited | Rm 717 7th Flr Houston Centre, Tst East Kowloon | Manufacturer of Bedding & Upholstered Furniture | 2011-05-25 ~ 2012-04-30 |
| Patricia C Gerckens | 73 Kings Court, Derby, CT 06418-2241 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Arthur T Gerckens | 374 Hawthorne Avenue, Derby, CT 06418 | Notary Public Appointment | 2015-09-01 ~ 2020-08-31 |
| Kevin A Gerckens | 65 Hillcrest Avenue, Derby, CT 06418 | Notary Public Appointment | 2020-05-01 ~ 2025-04-30 |
| Physician Assistant Foundation of The American Academy of Physician Assistants | 2318 Mill Rd Ste 1300, Alexandria, VA 22314-6868 | Public Charity | 2019-12-01 ~ 2020-11-30 |
| Patsy Depalmer IIi Building + Remodeling LLC | 901 Baldwin Rd, Woodbridge, CT 06525-2408 | Home Improvement Contractor | 2019-01-08 ~ 2019-11-30 |
| Theresa V Horvath | Physiican Assistant Institute, Bridgeport, CT 06604 | Physician Assistant | 2018-10-01 ~ 2019-09-30 |
Please comment or provide details below to improve the information on PATSY A GERCKENS 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).