BRIAN R THEROUX PA
Physician Assistant


Address: 23 Knight Hill Rd, Clayville, RI 02815

BRIAN R THEROUX PA (Credential# 743205) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is May 19, 2004. The license expiration date date is May 31, 2005. The license status is INACTIVE.

Business Overview

BRIAN R THEROUX PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001456. The credential type is physician assistant. The effective date is May 19, 2004. The expiration date is May 31, 2005. The business address is 23 Knight Hill Rd, Clayville, RI 02815. The current status is inactive.

Basic Information

Licensee Name BRIAN R THEROUX PA
Credential ID 743205
Credential Number 23.001456
Credential Type Physician Assistant
Business Address 23 Knight Hill Rd
Clayville
RI 02815
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2004-02-20
Effective Date 2004-05-19
Expiration Date 2005-05-31
Refresh Date 2009-07-10

Other licenses

ID Credential Code Credential Type Issue Term Status
367772 CSP.0034774 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2004-04-16 - 2005-02-28 INACTIVE
653284 10.R53540 Registered Nurse 1996-11-29 - 1997-05-31 INACTIVE

Office Location

Street Address 23 KNIGHT HILL RD
City CLAYVILLE
State RI
Zip Code 02815

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Peter A King 36 George Washington, Clayville, RI 02815 Sub-surface Sewage Installer 2020-03-01 ~ 2021-02-28
Arthur W Ihloff Jr 463 Field Hill Road, Clayville, RI 02815 Casino Class I Employee 2019-12-03 ~ 2020-10-31
Lisa J Adams 120 Knight Hill Rd, Clayville, RI 02815 Pharmacist 2020-02-01 ~ 2022-01-31
Deborah A Varrieur 170 George Washington, Clayville, RI 02815 Registered Nurse 2004-08-02 ~ 2005-09-30
Jacqueline Gervais Karam 280 Field Hill Rd, Clayville, RI 02815-1101 Real Estate Salesperson 2020-06-01 ~ 2021-05-31
Steven J Langford · Dozer Materials 316 Field Hill Rd, Clayville, RI 02815-1102 Home Improvement Contractor 2019-08-08 ~ 2019-11-30
Steven J Mottola 72 Knight Hill Rd, Clayville, RI 02815-1113 Electrical Unlimited Journeyperson 2018-10-01 ~ 2019-09-30
Cara A. Mottola 72 Knight Hill Rd, Clayville, RI 02815-1113 Dental Hygienist 2016-05-01 ~ 2017-04-30
Michelle Elizabeth Donahue 1485 Plainfield Pike, Clayville, RI 02815-1129 Registered Nurse 2020-02-01 ~ 2021-01-31

Licenses in the same city

Licensee Name Office Address Credential Effective / Expiration
Kimberly Mary Weeden 207 Camp Rd, Clayville, NY 13322 Registered Nurse 2015-05-01 ~ 2016-05-31
Joann M Perkins 163 Main St, Clayville, NY 13322 Registered Nurse 1993-01-25 ~ 1993-12-31

Competitor

Search similar business entities

City CLAYVILLE
Zip Code 02815
License Type Physician Assistant
License Type + County Physician Assistant + CLAYVILLE

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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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