ANNETTE I CRUZ PA-C (Credential# 743722) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2016. The license expiration date date is May 31, 2017. The license status is INACTIVE.
ANNETTE I CRUZ PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001973. The credential type is physician assistant. The effective date is June 1, 2016. The expiration date is May 31, 2017. The business address is 604 Galera Ln, Mount Pleasant, SC 29464-8318. The current status is inactive.
| Licensee Name | ANNETTE I CRUZ PA-C |
| Credential ID | 743722 |
| Credential Number | 23.001973 |
| Credential Type | Physician Assistant |
| Business Address |
604 Galera Ln Mount Pleasant SC 29464-8318 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2007-09-24 |
| Effective Date | 2016-06-01 |
| Expiration Date | 2017-05-31 |
| Refresh Date | 2017-09-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 485578 | CSP.0042748 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-10-25 | 2015-03-01 - 2017-02-28 | INACTIVE |
| 842580 | 70.002847 | Emergency Medical Technician | 2002-08-22 | 2002-08-22 - 2004-04-01 | INACTIVE |
| Street Address | 604 GALERA LN |
| City | MOUNT PLEASANT |
| State | SC |
| Zip Code | 29464-8318 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth L Egan | 1481 Center St Extension Unit 106, Mt. Pleasant, SC 29464 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Taipobo Kagor Tairodskiy | 1549 Carolina Jasmine Road, Mt. Pleasant, SC 29464 | Liquor Brand Label | 2017-04-05 ~ 2020-04-03 |
| Avery C Spalding | 30 Hopetown Road, Mount Pleasant, SC 29464 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Abby Kent Teachey | 1061 Johnnie Dodds Blvd, Apt D1, Mount Pleasant, SC 29464 | Registered Nurse | ~ |
| John Drew Astles | 1132 Club Terrace, Mount Pleasant, SC 29464 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Phyllis M Nelson | 2537 Bent Tree Lane, Mt Pleasant, SC 29464 | Registered Nurse | 2018-10-01 ~ 2019-09-30 |
| Jeffrey Tkacz | 1481 Oaklanding Road, Mt. Pleasant, SC 29464 | Certified Public Accountant Certificate | 2020-01-01 ~ 2020-12-31 |
| Alana Fusco | 256 Mossy Oak Way, Mount Pleasant, SC 29464 | Registered Nurse | 2018-09-01 ~ 2019-08-31 |
| Linda L Felner · Designs By Felner | 1266 Gannett Rd., Mt. Pleasant, SC 29464 | Interior Designer | 2020-01-01 ~ 2020-12-31 |
| Mckenna Beam | 323 Harbor Pointe Dr Apt #12, Mount Pleasant, SC 29464 | Home Improvement Salesperson | 2019-12-01 ~ 2020-11-30 |
| Find all Licenses in zip 29464 | |||
| City | MOUNT PLEASANT |
| Zip Code | 29464 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + MOUNT PLEASANT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Annette Pope-morris | 227 Randall Ave, Freeport, NY 11520-2644 | Physician Assistant | 2014-07-01 ~ 2015-06-30 |
| Amanda A Cruz | 9 Jamestown Cir, Wallingford, CT 06492-2138 | Physician Assistant | 2013-06-03 ~ 2014-06-30 |
| Andrew M Cruz | 3354 83rd St Apt E31, Jackson Heights, NY 11372-1480 | Physician Assistant | ~ |
| Yvette L Cruz Pa | 1371 Lancelot Way, Casselberry, FL 32707 | Physician Assistant | 2007-12-21 ~ 2008-12-31 |
| Annette N Aubert | 84 Westside Blvd, Burlington, CT 06013-2527 | Occupational Therapist Assistant | 2019-10-17 ~ 2021-07-31 |
| Annette T Eshelman | 330 S. 23rd Street, La Crosse, WI 54601 | Occupational Therapist Assistant | 2009-07-15 ~ 2011-07-31 |
| Annette Piccirillo | 32 New St., Shelton, CT 06484 | Family Child Care Assistant | 1997-02-28 ~ 1999-04-30 |
| 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 |
| Annette Goslin | 182 Chestnut Hill Rd, Colchester, CT 06415 | Family Child Care Assistant | 2000-12-31 ~ 2000-12-31 |
| Nurys De La Cruz | 10 Chamberlain St, New Haven, CT 06512-1603 | Family Child Care Assistant | ~ |
Please comment or provide details below to improve the information on ANNETTE I CRUZ PA-C.
| 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).