LAURA D WILK PA
Physician Assistant


Address: 539 Smithtown Ave, Bohemia, NY 11716

LAURA D WILK PA (Credential# 743214) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is October 3, 2007. The license expiration date date is October 31, 2008. The license status is INACTIVE.

Business Overview

LAURA D WILK PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001465. The credential type is physician assistant. The effective date is October 3, 2007. The expiration date is October 31, 2008. The business address is 539 Smithtown Ave, Bohemia, NY 11716. The current status is inactive.

Basic Information

Licensee Name LAURA D WILK PA
Credential ID 743214
Credential Number 23.001465
Credential Type Physician Assistant
Business Address 539 Smithtown Ave
Bohemia
NY 11716
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2004-03-17
Effective Date 2007-10-03
Expiration Date 2008-10-31
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
369411 CSP.0034872 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2004-06-17 2007-03-01 - 2008-02-29 INACTIVE

Office Location

Street Address 539 SMITHTOWN AVE
City BOHEMIA
State NY
Zip Code 11716

Licenses in the same zip code

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Emily Torre 1014 Karshick Street, Bohemi, Bohemia, NY 11716 Master's Level Social Worker ~
Pfm Funds One Corporate Drive, Bohemia, NY 11716 Filing Company (icoe) 2019-12-31 ~ 2020-12-31
Victor E Schaller Jr 1314 Smithtown Avenue 4, Bohemia, NY 11716 Tax Preparer/facilitator Permit 2020-02-11 ~ 2022-02-28
George Moglia Jr 14 Phillips St, Bohemia, NY 11716 Professional Engineer 2020-02-01 ~ 2021-01-31
Sally Ferrante 1620 Louis Kossuth Avenue, Bohemia, NY 11716 Notary Public Appointment 2009-09-01 ~ 2014-09-30
Johnny D Conner Jr 90-16 Middletown Rd, Bohemia, NY 11716 Home Improvement Salesperson 2000-01-13 ~ 2000-11-30
Heidi's Cake · Heid's Bake Shop Inc Dba 75 Cariough Rd, Bohemia, NY 11716 Bakery 1997-07-01 ~ 1998-06-30
Johnathan Lord Corp 87 Carlough Rd, Bohemia, NY 11716 Bakery 1996-09-09 ~ 1997-06-30
King Quality Siding & Windows Inc 1615 Sycamore Ave, Bohemia, NY 11716 Home Improvement Contractor 2007-12-01 ~ 2008-11-30
Triad Counter Corp 1641 Sycamore Ave, Bohemia, NY 11716 Home Improvement Contractor 2007-12-01 ~ 2008-11-30
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Competitor

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City BOHEMIA
Zip Code 11716
License Type Physician Assistant
License Type + County Physician Assistant + BOHEMIA

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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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