NANCY LOPEZ PA (Credential# 743371) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2015. The license expiration date date is July 31, 2016. The license status is INACTIVE.
NANCY LOPEZ PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001622. The credential type is physician assistant. The effective date is August 1, 2015. The expiration date is July 31, 2016. The business address is 815 South Rd, Westbrookville, NY 12785-0448. The current status is inactive.
| Licensee Name | NANCY LOPEZ PA |
| Credential ID | 743371 |
| Credential Number | 23.001622 |
| Credential Type | Physician Assistant |
| Business Address |
815 South Rd Westbrookville NY 12785-0448 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2005-04-18 |
| Effective Date | 2015-08-01 |
| Expiration Date | 2016-07-31 |
| Refresh Date | 2016-11-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 981609 | CSP.0049544 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2011-01-19 | 2013-03-01 - 2015-02-28 | INACTIVE |
| Street Address | 815 SOUTH RD |
| City | WESTBROOKVILLE |
| State | NY |
| Zip Code | 12785-0448 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Abigail Renee Coatney | 169 Pine Kill Rd, Westbrookville, NY 12785 | Behavior Analyst | ~ |
| Michael W Flores | 16 Pilipski Dr, Westbrookville, NY 12785 | Plumbing & Piping Limited Journeyperson | ~ |
| John H Pintka Jr | 698 Pine Hill Road, Westbrookville, NY 12785 | Tv & Radio Limited Dish Antenna Technician | ~ |
| Ross Macneil | 1551 Us Rte 209, Westbrookville, NY 12785 | Electrical Unlimited Journeyperson | ~ |
| Jeff D Reed | 4 Elm St, Westbrookville, NY 12785 | Electrical Unlimited Journeyperson | ~ |
| William D Norris | Po Box 573, Westbrookville, NY 12785 | Electrical Unlimited Journeyperson | ~ |
| Victoria Gilyard | 1624 State Route 209, Westbrookville, NY 12785-5013 | Registered Nurse | ~ |
| City | WESTBROOKVILLE |
| Zip Code | 12785 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + WESTBROOKVILLE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kristen M Lopez | 747 3rd St Ne, Washington, DC 20002-4311 | Physician Assistant | 2016-06-01 ~ 2017-05-31 |
| Kristina Lopez | 109 Kaye Vue Drive, Hamden, CT 06514 | Physician Assistant | ~ 1996-01-31 |
| Peter Joseph Lopez Pa | 63 Pinacle Rd, Glastonbury, CT 06033-2521 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| George A Lopez Pa | 1759 W End Ave, New Hyde Park, NY 11040-4024 | Physician Assistant | 2019-12-01 ~ 2020-11-30 |
| Rolando R Lopez | 22 Tyler City Rd, Orange, CT 06477 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Nancy K Staley Pa | 21 Schilke Dr, Westerly, RI 02891-1402 | Physician Assistant | 2017-12-01 ~ 2018-11-30 |
| Nancy Santaniello Pa | 81 Rhinebeck Ave, Springfield, MA 01129 | Physician Assistant | 2018-03-01 ~ 2019-02-28 |
| Nancy E Jean | 1345 Rxr Plz, Uniondale, NY 11556-1301 | Physician Assistant | 2017-06-01 ~ 2018-05-31 |
| Nancy C Kelley | 24 Bayberry Ln, Redding, CT 06896-1828 | Physician Assistant | 2015-03-31 ~ 2015-11-30 |
| Nancy F Arena Pa | 85 Seymour St #700, Hartford, CT 06106 | Physician Assistant | 2006-02-01 ~ 2007-03-31 |
Please comment or provide details below to improve the information on NANCY LOPEZ PA.
| 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).