NICOLE S KAPETANOS
Physician Assistant


Address: 18-65 215th Street, Bayside, NY 11360

NICOLE S KAPETANOS (Credential# 743510) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2009. The license expiration date date is August 31, 2010. The license status is INACTIVE.

Business Overview

NICOLE S KAPETANOS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001761. The credential type is physician assistant. The effective date is September 1, 2009. The expiration date is August 31, 2010. The business address is 18-65 215th Street, Bayside, NY 11360. The current status is inactive.

Basic Information

Licensee Name NICOLE S KAPETANOS
Credential ID 743510
Credential Number 23.001761
Credential Type Physician Assistant
Business Address 18-65 215th Street
Bayside
NY 11360
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2006-02-21
Effective Date 2009-09-01
Expiration Date 2010-08-31
Refresh Date 2010-12-01

Office Location

Street Address 18-65 215TH STREET
City BAYSIDE
State NY
Zip Code 11360

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City BAYSIDE
Zip Code 11360
License Type Physician Assistant
License Type + County Physician Assistant + BAYSIDE

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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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