SUZZUNNE N DECRUZ (Credential# 743182) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
SUZZUNNE N DECRUZ is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001433. The credential type is physician assistant. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 240 Indian River Rd Ste A5, Orange, CT 06477-3690. The current status is active.
| Licensee Name | SUZZUNNE N DECRUZ |
| Credential ID | 743182 |
| Credential Number | 23.001433 |
| Credential Type | Physician Assistant |
| Business Address |
240 Indian River Rd Ste A5 Orange CT 06477-3690 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2003-12-02 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-02-19 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 364744 | CSP.0034626 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2004-03-04 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 240 INDIAN RIVER RD STE A5 |
| City | ORANGE |
| State | CT |
| Zip Code | 06477-3690 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| David B Simon Md | 240 Indian River Rd Ste A5, Orange, CT 06477-3627 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marie F Robert | 240 Indian River Rd Ste B1, Orange, CT 06477-3690 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Smilow Cancer Hospital | 240 Indian River Rd Ste A1, Orange, CT 06477-3690 | Controlled Substance Registration for Hospitals | 2019-03-01 ~ 2021-02-28 |
| Pei Juan Salerno | 240 Indian River Rd, Orange, CT 06477-3690 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelsey Thompson Martin | 240 Indian River Rd Ste A1, Orange, CT 06477-3690 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rakesh H Patel Md | 596 Cedar Grove, Orange, CT 06477 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| John D Mainwaring Dds | 240 Indian River Rd, Suite A7, Orange, CT 06477 | Dentist | 2020-08-01 ~ 2021-07-31 |
| Hea Sun Kwak | 477 Howellton Rd, Orange, CT 06477 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2021-08-31 |
| Munsons Candy Kitchen Inc | 109 Boston Post Rd, Orange, CT 06477 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Takashi Yoshikawa | 151 Old Tavern Road, Orange, CT 06477 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Yam Wong | 21 Country Club Close, Orange, CT 06477 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Shitong Liu | 519 Boston Post Rd Orange, Orange, CT 06477 | Nail Technician | ~ |
| Robert A Lamparski | Po B0x# 1183, Orange, CT 06477 | Real Estate Salesperson | 2019-06-01 ~ 2020-05-31 |
| Rolando R Lopez | 22 Tyler City Rd, Orange, CT 06477 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Lisa Courtney | 470 Locust Drive, Orange, CT 06477 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Find all Licenses in zip 06477 | |||
| City | ORANGE |
| Zip Code | 06477 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + ORANGE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Physician Assistant Foundation of The American Academy of Physician Assistants | 2318 Mill Rd Ste 1300, Alexandria, VA 22314-6868 | Public Charity | 2019-12-01 ~ 2020-11-30 |
| Theresa V Horvath | Physiican Assistant Institute, Bridgeport, CT 06604 | Physician Assistant | 2018-10-01 ~ 2019-09-30 |
| Quinnipiac University Physician Assistant Student Society | 370 Bassett Rd, North Haven, CT 06473-4201 | Raffle Permit Class 1 | 2017-01-12 ~ 2017-04-08 |
| Connecticut Dermatology Physician Assistant Society Inc. | Po Box 847, Manchester, CT 06045 | Public Charity-exempt From Financial Requirements | ~ |
| Gretchen Treves | Physician One Urgent Care, Brookfield, CT 06804 | Physician Assistant | ~ |
| James H Brown | 11-c Cos Cob Ave, Cos Cob, CT 06807 | Physician Assistant | 2005-11-15 ~ 2006-11-30 |
| Suechu Eng Taing | Po Box 304, Rosemead, CA 91770-0304 | Physician Assistant | ~ |
| Stacey Rydzewska | 421 S End Rd, Plantsville, CT 06479 | Physician Assistant | ~ |
| L. Katherine Grasso | Po Box 191, Sudbury, MA 01776-0191 | Physician Assistant | ~ |
| Mia F Williams | 3 Old Oak Rd, Norwich, CT 06360-1500 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
Please comment or provide details below to improve the information on SUZZUNNE N DECRUZ.
| 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).