REBECCA J BRANDENBURG PA (Credential# 743664) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 14, 2008. The license expiration date date is April 30, 2009. The license status is INACTIVE.
REBECCA J BRANDENBURG PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001915. The credential type is physician assistant. The effective date is March 14, 2008. The expiration date is April 30, 2009. The business address is 274 Noble St, West Haven, CT 06156. The current status is inactive.
| Licensee Name | REBECCA J BRANDENBURG PA |
| Credential ID | 743664 |
| Credential Number | 23.001915 |
| Credential Type | Physician Assistant |
| Business Address |
274 Noble St West Haven CT 06156 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2007-06-26 |
| Effective Date | 2008-03-14 |
| Expiration Date | 2009-04-30 |
| Refresh Date | 2009-08-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 477302 | CSP.0041960 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-07-23 | 2008-03-01 - 2009-02-28 | INACTIVE |
| Street Address | 274 NOBLE ST |
| City | WEST HAVEN |
| State | CT |
| Zip Code | 06156 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Timothy Greene | 274 Noble St, West Haven, CT 06516-5916 | Emergency Medical Responder | 2019-04-12 ~ 2022-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Forel Kourouma | 36 Alling St. West Haven, Ct, West Haven, CT 06156 | Emergency Medical Technician | ~ |
| Sabrina Daly | 151 Farmington, Hartford, CT 06156 | Registered Nurse | 2019-03-20 ~ 2020-02-29 |
| Phillip J Lerner | 151 Farmington Avenue, Hartford, CT 06156 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Shilpa D Thakur | Aetna, Hartford, CT 06156 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Aetna Life & Casualty | City Place 2nd Flr Cafeteria, Hartford, CT 06156 | Frozen Dessert Retailer | 1996-03-01 ~ 1996-12-31 |
| Aetna Vending | 151 Farmington Ave-raaa, Hartford, CT 06156 | Vending Machine Operator | 2001-07-01 ~ 2002-06-30 |
| Yvonne Watson | 25 Terrace Avenue, West Haven, CT 06156 | Family Child Care Substitute | 2009-06-04 ~ 2011-06-30 |
| Susan B Blalock · Aetna Business Resources | 151 Farmington Ave Yf8y, Hartford, CT 06156 | Interior Designer | 1995-07-01 ~ 1996-12-31 |
| Thomas D Gotowka | Aetna Dental Care, Hartford, CT 06156 | Dentist | 2002-05-28 ~ 2003-07-31 |
| Edward J Smith | Aushc Quality Mgmnt, Hartford, CT 06156 | Physician/surgeon | 1999-12-30 ~ 2000-11-30 |
| Find all Licenses in zip 06156 | |||
| City | WEST HAVEN |
| Zip Code | 06156 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + WEST HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rebecca Wong | 61-17 231st, Bayside, NY 11364 | Physician Assistant | ~ |
| Rebecca L Hill | 341 Hudson Ave, Beacon, NY 12508-3621 | Physician Assistant | 2017-03-01 ~ 2018-02-28 |
| Rebecca D Jeffery | 28 Far Horizon Dr, Cheshire, CT 06410-2812 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Rebecca E Holberg Pa | 55 Nye Road, Glastonbury, CT 06033 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Rebecca R Scarano | 102 Dinsorette Ln, Apex, NC 27539-9032 | Physician Assistant | 2018-11-01 ~ 2019-10-31 |
| Rebecca E Score Pa | 200 West Road, Ellington, CT 06029 | Physician Assistant | 1999-06-11 ~ 2000-04-30 |
| Rebecca O'neill | 3 Wessels Place, Greenwich, CT 06830 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Rebecca S Karlowicz | 16 Woodmont Cir, East Haddam, CT 06423-1565 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Rebecca Press | 17 Pepperbush Lane, Glastonbury, CT 06033 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Rebecca L Katkocin | 2 Byebrook Court, New Fairfield, CT 06812 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
Please comment or provide details below to improve the information on REBECCA J BRANDENBURG 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).