STEVEN W KREISHER PA
Physician Assistant


Address: 31 Atwater St, Derby, CT 06418

STEVEN W KREISHER PA (Credential# 743061) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is September 29, 2006. The license expiration date date is November 30, 2007. The license status is INACTIVE.

Business Overview

STEVEN W KREISHER PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001312. The credential type is physician assistant. The effective date is September 29, 2006. The expiration date is November 30, 2007. The business address is 31 Atwater St, Derby, CT 06418. The current status is inactive.

Basic Information

Licensee Name STEVEN W KREISHER PA
Credential ID 743061
Credential Number 23.001312
Credential Type Physician Assistant
Business Address 31 Atwater St
Derby
CT 06418
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2002-12-17
Effective Date 2006-09-29
Expiration Date 2007-11-30
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
329718 CSP.0033073 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2005-03-01 - 2006-02-28 INACTIVE

Office Location

Street Address 31 ATWATER ST
City DERBY
State CT
Zip Code 06418

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City DERBY
Zip Code 06418
License Type Physician Assistant
License Type + County Physician Assistant + DERBY

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Dataset Information

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).

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