JUSTIN L CHAMPAGNE (Credential# 743470) 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.
JUSTIN L CHAMPAGNE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001721. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 11 Fox Hunt Way, Harwinton, CT 06791-2914. The current status is active.
| Licensee Name | JUSTIN L CHAMPAGNE |
| Credential ID | 743470 |
| Credential Number | 23.001721 |
| Credential Type | Physician Assistant |
| Business Address |
11 Fox Hunt Way Harwinton CT 06791-2914 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2005-11-03 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-03-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 420193 | CSP.0038492 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-11-08 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 841300 | 70.001566 | Emergency Medical Technician | 2001-06-29 | 2003-04-02 - 2005-03-31 | INACTIVE |
| Street Address | 11 FOX HUNT WAY |
| City | HARWINTON |
| State | CT |
| Zip Code | 06791-2914 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Heather L Champagne Pa-c | 11 Fox Hunt Way, Harwinton, CT 06791-2914 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| James J Breda Jr | 17 Fox Hunt Way, Harwinton, CT 06791-2914 | Electrical Unlimited Contractor | 2019-10-01 ~ 2020-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth A Durstin | 57 Westleigh Dr, Harwinton, CT 06791 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Patricia L Balch | 209 Catlin Road, Harwinton, CT 06791 | Physical Therapist | 2020-08-01 ~ 2021-07-31 |
| Catherine J Penna | 21 Fitzpatrick Ave, Harwinton, CT 06791 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Eleni E Demetri | 234 Locust Road, Harwinton, CT 06791 | Real Estate Salesperson | ~ |
| Wendy A Napolitano · Napolitano | 75 Bogue Rd, Harwinton, CT 06791 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Suzanne S Barlow | 125 Harmony Hill Road, Harwinton, CT 06791 | Physical Therapist | 2020-09-01 ~ 2021-08-31 |
| Quinoco Inc | 1016 Migeon Ave, Torrington, CT 06791 | Operator of Weighing & Measuring Devices | 2019-08-01 ~ 2020-07-31 |
| Tina M Magill | 25 Locust Road, Harwinton, CT 06791 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Sean M Griffin | 15 Lily Pond Lane, Harwinton, CT 06791 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Matthew H Rood | 370 North Road, Harwinton, CT 06791 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Find all Licenses in zip 06791 | |||
| City | HARWINTON |
| Zip Code | 06791 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + HARWINTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Justin S Boyarsky | 560 1st Ave, New York, NY 10016-6402 | Physician Assistant | ~ |
| Justin P Spangler | 2114 Rhonda Ter, Henderson, NV 89074-0653 | Physician Assistant | ~ |
| Justin Thach | 5717 162nd St, Fresh Meadows, NY 11365-1416 | Physician Assistant | 2013-03-22 ~ 2013-07-31 |
| Rejean M Champagne · Champagne & Son Inc | 120 Eluree St, Manchester, CT 06040 | Home Improvement Contractor | ~ 1995-08-01 |
| Champagne Collet N/a Champagne | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2018-04-06 ~ 2021-04-05 |
| 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 |
| Bollinger Direct Champagne Champagne | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2014-05-08 ~ 2017-05-07 |
| Champagne Collet N/a Brut Champagne | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2018-04-06 ~ 2021-04-05 |
| Champagne Corbon Champagne Brut | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2012-06-18 ~ 2015-06-15 |
| Randy L Champagne | 10 Briarwood Ln, Durham, CT 06422-1219 | Occupational Therapist Assistant | 2017-08-01 ~ 2019-07-31 |
Please comment or provide details below to improve the information on JUSTIN L CHAMPAGNE.
| 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).