KRISTEN M TRACEY PA (Credential# 742908) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 4, 2005. The license expiration date date is March 31, 2006. The license status is INACTIVE.
KRISTEN M TRACEY PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001159. The credential type is physician assistant. The effective date is March 4, 2005. The expiration date is March 31, 2006. The business address is 81-14 Topgallant Rd, Stamford, CT 06902. The current status is inactive.
| Licensee Name | KRISTEN M TRACEY PA |
| Credential ID | 742908 |
| Credential Number | 23.001159 |
| Credential Type | Physician Assistant |
| Business Address |
81-14 Topgallant Rd Stamford CT 06902 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2001-12-12 |
| Effective Date | 2005-03-04 |
| Expiration Date | 2006-03-31 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 305552 | CSP.0031908 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-03-01 - 2006-02-28 | INACTIVE |
| Street Address | 81-14 TOPGALLANT RD |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeris Maydeli Flores | 153 Fairfield Av, Stamford, CT 06902 | Nail Technician | ~ |
| Reynaldo De La Cruz | 64 Brookside Drive, Stamford, CT 06902 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Darren J Petillo | 5 Hundley Court, Stamford, CT 06902 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Antonios Restaurant | 405 West Main St, Stamford, CT 06902 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Edward Smith | 184 Fairfield Ave., Stamford, CT 06902 | Home Improvement Contractor | ~ |
| Margaret A Dorrance | 24c Hamilton Court, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carolyn Maguire | 48 Nelson St, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Evelyne Joassin | 17 George St., Stamford, CT 06902 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Andrea Bynoe | 34 Melrose Pl, Stamford, CT 06902 | Notary Public Appointment | 1994-04-06 ~ 1999-04-30 |
| Ravi K Ahuja | 296 Westover Rd, Stamford, CT 06902 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06902 | |||
| City | STAMFORD |
| Zip Code | 06902 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + STAMFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Tracey C Sheedy Pa | 7 Granite Road, New Milford, CT 06776-3089 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Tracey M Dixon | 75 Dunston Avenue, Yonkers, NY 10701 | Physician Assistant | 2019-07-01 ~ 2020-06-30 |
| Kristen M Lopez | 747 3rd St Ne, Washington, DC 20002-4311 | Physician Assistant | 2016-06-01 ~ 2017-05-31 |
| Kristen Lee Harger | 24 Adams Dr, Terryville, CT 06786-6013 | Physician Assistant | ~ |
| Kristen L Rinaldi Pa-c | 387 Oak Drive, Watertown, CT 06795 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Kristen A Baker | 4 Allison Dr, Madison, CT 06443-2174 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Kristen M Kinslow | 68 Dexter Dr, Shelton, CT 06484 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Kristen J Mosher | 30 Lakeview Terrace, Derby, CT 06418 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Kristen Murrone Diamond | 11 Pettibone Dr, Simsbury, CT 06070-2615 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Miriam Kristen Wiggins | 166 Nottingham Dr, East Longmeadow, MA 01028-2631 | Physician Assistant | ~ |
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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).