STACY ANNE HENDERSON PA (Credential# 742839) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
STACY ANNE HENDERSON PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001090. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 41 Germantown Rd Ste 101, Danbury, CT 06810-4087. The current status is active.
| Licensee Name | STACY ANNE HENDERSON PA |
| Credential ID | 742839 |
| Credential Number | 23.001090 |
| Credential Type | Physician Assistant |
| Business Address |
41 Germantown Rd Ste 101 Danbury CT 06810-4087 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2001-07-19 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-05-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 292814 | CSP.0031555 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2001-10-30 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 41 GERMANTOWN RD STE 101 |
| City | DANBURY |
| State | CT |
| Zip Code | 06810-4087 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alan M Dietzek | 41 Germantown Rd Ste 101, Danbury, CT 06810-4087 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Dahlia Plummer | 41 Germantown Rd Ste 101, Danbury, CT 06810-4087 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Benjamin Chandler | 41 Germantown Rd Ste 101, Danbury, CT 06810-4087 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eastern College Athletic Conference Inc | Matrix Corp Ctr 39 Old Ridgebury Rd, Danbury, CT 06810 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Subway #36533 | 67 Newtown Rd, Danbury, CT 06810 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Natali Salome Teran | 27 Balmforth Ave 2, Danbury, CT 06810 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-06-30 |
| Kristin Danielle Mehta | 33 Country View Road, Danbury, CT 06810 | Advanced Practice Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Zhane Gabrielle Cardenas | 40 Westville Avenue Apt 1, Danbury, CT 06810 | Nail Technician | 2020-06-27 ~ 2021-09-30 |
| Zhane E Willikinson | 30 Germantown Road Suite 117, Danbury, CT 06810 | Nail Technician | 2020-06-27 ~ 2022-03-31 |
| Michelle Dahlgren | 8 Stable Drive, Danbury, CT 06810 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Asheree P Griffin | 14 New Town Road, Danbury, CT 06810 | Real Estate Salesperson | ~ |
| Tania Isabel Salazar | 20 Highland Avenue, Danbury, CT 06810 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-05-31 |
| Gregory C Banks | Gregory Banks Counseling, LLC, Danbury, CT 06810 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06810 | |||
| City | DANBURY |
| Zip Code | 06810 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + DANBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Stacy S Adil | 84 Hawthorne Ave, Hamden, CT 06517-1825 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Justin P Spangler | 2114 Rhonda Ter, Henderson, NV 89074-0653 | Physician Assistant | ~ |
| Stacy Fuller Baecker Pa-c | 28 Magnolia Ave, Norwalk, CT 06850-3631 | Physician Assistant | 2010-09-01 ~ 2011-08-31 |
| Stacy Holtz Pa | 245 Jeremy Swamp Road, Southbury, CT 06488 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Stacy E Shimp | 1673 Ludwell Drive, Ambler, PA 19002 | Physician Assistant | 2019-12-01 ~ 2020-11-30 |
| Scott E Henderson | 2390 State Street, Hamden, CT 06517 | Physician Assistant | 2000-10-26 ~ 2001-06-30 |
| Jasmine Palmiano Henderson | 5717 Pacific Center Blvd Ste 200, San Diego, CA 92121-4250 | Physician Assistant | 2020-09-01 ~ 2021-08-31 |
| Stacy Alex Robinson | 8246 Azur Coast Boulevard, Lake Worth, FL 33467 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Jessica Anne Mcdonald | 1 Primrose Ln Apt 2k, Fords, NJ 08863-1192 | Physician Assistant | ~ |
| Anne M Keck Pa-c | 5 Wildwood Rd, Vernon, CT 06066 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
Please comment or provide details below to improve the information on STACY ANNE HENDERSON 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).