BEVERLY J WACZEK
Physician Assistant


Address: 57 Sprain Brook Rd, Woodbury, CT 06798

BEVERLY J WACZEK (Credential# 743226) 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.

Business Overview

BEVERLY J WACZEK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001477. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 57 Sprain Brook Rd, Woodbury, CT 06798. The current status is active.

Basic Information

Licensee Name BEVERLY J WACZEK
Credential ID 743226
Credential Number 23.001477
Credential Type Physician Assistant
Business Address 57 Sprain Brook Rd
Woodbury
CT 06798
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2004-06-02
Effective Date 2020-06-01
Expiration Date 2021-05-31
Refresh Date 2020-05-18

Other licenses

ID Credential Code Credential Type Issue Term Status
408254 CSP.0037666 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2005-06-24 2019-03-01 - 2021-02-28 ACTIVE

Office Location

Street Address 57 SPRAIN BROOK RD
City WOODBURY
State CT
Zip Code 06798

Licenses in the same location

Licensee Name Office Address Credential Effective / Expiration
John A Manouse 57 Sprain Brook Rd, Woodbury, CT 06798-1912 Community Association Manager 2017-01-19 ~ 2018-01-31

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Russell J Hardy 229 Bacon Pond Rd #114, Woodbury, CT 06798 Registered Nurse 2020-07-01 ~ 2021-06-30
Geoffrey S Middeleer 20 Roxbury Road, Woodbury, CT 06798 Landscape Architect 2020-08-01 ~ 2021-07-31
Elaine P Templeton 197 Carmel Hill Road, Woodbury, CT 06798 Real Estate Salesperson ~
Ayrica L Gelinas 65 Laurel Woods Road, Woodbury, CT 06798 Hairdresser/cosmetician 2020-09-01 ~ 2022-08-31
Christopher R Laux Grey Fox Trail, Woodbury, CT 06798 Architect 2020-08-01 ~ 2021-07-31
Diane L Robinson P O Box 208, Woodbury, CT 06798 Registered Nurse 2020-08-01 ~ 2021-07-31
Scott Freitag 47 Woodbury Hill, Woodbury, CT 06798 Medication Administration Certification ~
Brenda L Lupo 31 Blueberry Lane, Woodbury, CT 06798 Registered Nurse 2020-07-01 ~ 2021-06-30
Jennifer L Thompson 1280 Main St. North, Woodbury, CT 06798 Licensed Clinical Social Worker 2020-08-01 ~ 2021-07-31
Eileen O Pflegl 3 Hazel Plain Road, Woodbury, CT 06798 Hairdresser/cosmetician 2020-08-01 ~ 2022-07-31
Find all Licenses in zip 06798

Competitor

Search similar business entities

City WOODBURY
Zip Code 06798
License Type Physician Assistant
License Type + County Physician Assistant + WOODBURY

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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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