AMANDA G MADKOUR (Credential# 743148) 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.
AMANDA G MADKOUR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001399. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 51-53 Kenosia Ave, Danbury, CT 06810-2304. The current status is active.
| Licensee Name | AMANDA G MADKOUR |
| Credential ID | 743148 |
| Credential Number | 23.001399 |
| Credential Type | Physician Assistant |
| Business Address |
51-53 Kenosia Ave Danbury CT 06810-2304 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2003-10-06 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-03-10 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 356463 | CSP.0034407 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2003-12-17 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 51-53 KENOSIA AVE |
| City | DANBURY |
| State | CT |
| Zip Code | 06810-2304 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrea H Russo | 51-53 Kenosia Ave, Danbury, CT 06810-2304 | Resident Physician | 2015-05-18 ~ 2021-06-30 |
| J James Bruno II | 51-53 Kenosia Ave, Danbury, CT 06810 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Jennifer Rebecca Hill | 51-53 Kenosia Ave, Danbury, CT 06810 | Physician/surgeon | ~ |
| 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 |
|---|---|---|---|
| Amanda J Cullen Pa-c | 38 Zacks Way, Agawam, MA 01001-3246 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Amanda F Votto Pa-c | 283 S Main St, Wallingford, CT 06492-4602 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Amanda L Orszulak | 90 Greenacre Ave, Longmeadow, MA 01106-1906 | Physician Assistant | 2012-08-06 ~ 2013-05-31 |
| Amanda A Cruz | 9 Jamestown Cir, Wallingford, CT 06492-2138 | Physician Assistant | 2013-06-03 ~ 2014-06-30 |
| Amanda Denny | 18 Shawondassee Drive, Stonington, CT 06378 | Physician Assistant | 2018-11-01 ~ 2019-11-30 |
| Emily Amanda Durocher | 173 Rochela Dr, Southington, CT 06489-4671 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Amanda Mauck | 241 Erin Drive, Cranberry Township, PA 16066 | Physician Assistant | ~ |
| Amanda J Mccabe | 189 Cornwall Hill Rd, Patterson, NY 12563-2551 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Amanda Linn Paradiso | 90 Weathervane Dr, New Milford, CT 06776 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Amanda Nesis | 214 Farms Road, Brewster, NY 10509 | Physician Assistant | 2003-03-17 ~ 2004-05-31 |
Please comment or provide details below to improve the information on AMANDA G MADKOUR.
| 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).