MARTIN J KELLY (Credential# 742728) 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.
MARTIN J KELLY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000979. The credential type is physician assistant. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 42 Joshua Lane, Coventry, CT 06238. The current status is active.
Licensee Name | MARTIN J KELLY |
Credential ID | 742728 |
Credential Number | 23.000979 |
Credential Type | Physician Assistant |
Business Address |
42 Joshua Lane Coventry CT 06238 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2000-07-25 |
Effective Date | 2020-05-01 |
Expiration Date | 2021-04-30 |
Refresh Date | 2020-02-10 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
263020 | CSP.0030656 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2001-03-16 | 2017-03-01 - 2019-02-28 | LAPSED |
857886 | 70.890145 | Emergency Medical Technician | 1989-01-09 | - 1991-03-31 | INACTIVE |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Martin J Kelly | 1 Alcima Dr, Simsbury, CT 06070-3057 | Real Estate Salesperson | ~ |
Martin J Kelly | 1 Lakewoods Lane, Columbia, CT 06237 | Professional Counselor | 2020-04-01 ~ 2021-03-31 |
Street Address | 42 Joshua Lane |
City | Coventry |
State | CT |
Zip Code | 06238 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Kimberly A Kelly · Bissonnette | 42 Joshua Lane, Coventry, CT 06238 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Parul S Shah · Bidwell Spirit Shoppe | 1220 Main St, Coventry, CT 06238 | Package Store Liquor | 2020-08-02 ~ 2021-08-01 |
Mary A Manton | 28 Armstrong Rd Unit B-9, Coventry, CT 06238 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
Barbara J Dillon | 93 Alice Drive, Coventry, CT 06238 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
Cody Adam Kirschbaum | 83 Daly Rd, Coventry, CT 06238 | Emergency Medical Technician | ~ |
Stephanie A Simmons | 878 Silver St, Coventry, CT 06238 | Licensed Practical Nurse | 2020-02-01 ~ 2021-01-31 |
Mellissa U Carroll | 349 Ripley Hill Rd, Coventry, CT 06238 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Kristin D'alfonso | 43 Windy Hill Road, Coventry, CT 06238 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
Dawn Trudeau | 46 Flanders River Road, Coventry, CT 06238 | Medication Administration Certification | 2020-06-28 ~ 2022-06-27 |
Bryan Trudel | 3505 South St., Coventry, CT 06238 | Backflow Prevention Device Tester | 2020-05-27 ~ 2023-03-31 |
Christopher Dean | 545 Flanders Rd., Coventry, CT 06238 | Backflow Prevention Device Tester | 2020-05-27 ~ 2023-03-31 |
Find all Licenses in zip 06238 |
City | Coventry |
Zip Code | 06238 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + Coventry |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Kelly Ann Meenan | 8 Lenmore Dr, Old Bethpage, NY 11804-1119 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
Kelly Donovan | 80 Seymour St, Hartford, CT 06102-8000 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
Kara Martin | 82 Hartford Ave W, Mendon, MA 01756-1035 | Physician Assistant | 2020-06-20 ~ 2021-03-31 |
Kelly M Pfau | 22 Broad Hill Cir, Guilford, CT 06437-1722 | Physician Assistant | 2017-11-01 ~ 2018-10-31 |
Adam C Kelly Pa | 1403 Horizon Way, Manchester, CT 06042 | Physician Assistant | 2008-03-04 ~ 2009-04-30 |
Kelly Irene Mitchell | 63 Paul Ter, Southington, CT 06489-4128 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
Kelly A Christman | 29 Peepers Holw, Greenwich, CT 06831-3225 | Physician Assistant | 2017-03-01 ~ 2018-02-28 |
Kelly B Cantu | 28 Huntingridge Dr, South Glastonbury, CT 06073-3612 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
Kelly Nguyen | 134 Wakefield Cir, East Hartford, CT 06118-1632 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
Kelly Rainey | 19 Bittersweet Lane, Ivoryton, CT 06442 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
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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).