MICHAEL C VERVILLE PA-C
Physician Assistant


Address: 40 Prospect Ave Bldg 1 Apt 1m, Norwalk, CT 06850

MICHAEL C VERVILLE PA-C (Credential# 743703) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is April 28, 2008. The license expiration date date is April 30, 2009. The license status is INACTIVE.

Business Overview

MICHAEL C VERVILLE PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001954. The credential type is physician assistant. The effective date is April 28, 2008. The expiration date is April 30, 2009. The business address is 40 Prospect Ave Bldg 1 Apt 1m, Norwalk, CT 06850. The current status is inactive.

Basic Information

Licensee Name MICHAEL C VERVILLE PA-C
Credential ID 743703
Credential Number 23.001954
Credential Type Physician Assistant
Business Address 40 Prospect Ave Bldg 1 Apt 1m
Norwalk
CT 06850
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2007-08-31
Effective Date 2008-04-28
Expiration Date 2009-04-30
Refresh Date 2009-08-13

Other licenses

ID Credential Code Credential Type Issue Term Status
484855 CSP.0042716 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2007-11-20 2008-03-01 - 2009-02-28 INACTIVE

Office Location

Street Address 40 PROSPECT AVE BLDG 1 APT 1M
City NORWALK
State CT
Zip Code 06850

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Competitor

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City NORWALK
Zip Code 06850
License Type Physician Assistant
License Type + County Physician Assistant + NORWALK

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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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