MARC BENJAMIN (Credential# 742740) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
MARC BENJAMIN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000991. The credential type is physician assistant. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 40 Glen Hollow, West Hartford, CT 06117-2224. The current status is active.
| Licensee Name | MARC BENJAMIN |
| Credential ID | 742740 |
| Credential Number | 23.000991 |
| Credential Type | Physician Assistant |
| Business Address |
40 Glen Hollow West Hartford CT 06117-2224 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2000-09-19 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-01-14 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 242541 | CSP.0030154 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2000-10-02 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marc Benjamin · Mastercraft Fence & Const | 125 Hunters Ave, Taftville, CT 06380-1031 | Emergency Medical Technician | 2014-10-28 ~ 2021-01-01 |
| Street Address | 40 Glen Hollow |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06117-2224 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| American Condor Construction LLC | 47 Miamis Rd, West Hartford, CT 06117-2224 | Home Improvement Contractor | 2020-05-18 ~ 2020-11-30 |
| Colleen D Tripp | 23 Miamis Rd, West Hartford, CT 06117-2224 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Joel K Gothold | 43 Miamis Rd, West Hartford, CT 06117-2224 | Pharmacist | 2016-02-01 ~ 2018-01-31 |
| Michelle C Urciuoli | 5 Miamis Rd, West Hartford, CT 06117-2224 | Real Estate Salesperson | 2013-06-01 ~ 2014-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cathy Tran | 20 Lindy Lane, West Hartford, CT 06117 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Renaissance Craftsmen LLC | 263 Simsbury Road, West Hartford, CT 06117 | Home Improvement Contractor | 2020-06-27 ~ 2020-11-30 |
| Lev Tsarkov | 116 Lyman Road, West Hartford, CT 06117 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Scott Lee Ratchford | 67 Balfour Dr., West Hartford, CT 06117 | Professional Counselor | ~ |
| Gary Neidle | 8 Stratford Rd, West Hartford, CT 06117 | Real Estate Salesperson | 2020-06-26 ~ 2021-05-31 |
| Beverly Vincent | 37 Harwich Lane, West Hartford, CT 06117 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Marc D Palter | 94 Beacon Hill Dr, West Hartford, CT 06117 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| David L Friar | 35 Porter Dr, W Hartford, CT 06117 | Architect | 2020-08-01 ~ 2021-07-31 |
| Adlin C Daye | 147 Mohawk Drive, West Hartford, CT 06117 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Derek M Mcdermott | 61 Ferncliff Drive, West Hartford, CT 06117 | Emergency Medical Technician | ~ |
| Find all Licenses in zip 06117 | |||
| City | WEST HARTFORD |
| Zip Code | 06117 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + WEST HARTFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marc Thomas Civitano | 51 Caprice Dr, Stamford, CT 06902 | Physician Assistant | ~ |
| Marc A Norman Pa-c | 40 Prospect Ave Apt 2, Norwalk, CT 06850-3737 | Physician Assistant | 2010-04-01 ~ 2011-03-31 |
| Marc S D'amato | 31 Strawberry Lane, Middlefield, CT 06455 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Marc Robert Feldmeier Pa | 41 Hunters Mtn Rd, Oxford, CT 06478 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Benjamin T Houston | 69 Oakleaf Dr, Waterbury, CT 06708-3632 | Physician Assistant | 2016-12-01 ~ 2017-11-30 |
| Marc Tabayoyong Campos | 189 Harland Road, Norwich, CT 06360 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Benjamin W Dodson | 552 Wallingford Road, Lancaster, PA 17601 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Benjamin A Wetstone | 26 Calvin Rd, West Hartford, CT 06110-2110 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Jerry A Benjamin | 54 Warwick St, West Hartford, CT 06119 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Benjamin T Gilbert | 290 N Hudson Ave Apt 308e, Pasadena, CA 91101-4429 | Physician Assistant | 2017-11-01 ~ 2018-10-31 |
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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).