AMANDA J CULLEN PA-C (Credential# 743755) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
AMANDA J CULLEN PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002006. The credential type is physician assistant. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 38 Zacks Way, Agawam, MA 01001-3246. The current status is active.
Licensee Name | AMANDA J CULLEN PA-C |
Credential ID | 743755 |
Credential Number | 23.002006 |
Credential Type | Physician Assistant |
Business Address |
38 Zacks Way Agawam MA 01001-3246 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2007-10-24 |
Effective Date | 2020-04-01 |
Expiration Date | 2021-03-31 |
Refresh Date | 2020-01-21 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
488178 | CSP.0042854 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-11-21 | 2019-03-01 - 2021-02-28 | ACTIVE |
Street Address | 38 ZACKS WAY |
City | AGAWAM |
State | MA |
Zip Code | 01001-3246 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
William H Cullen IIi | 38 Zacks Way, Agawam, MA 01001-3246 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Pamela J Freeman Brown | 1324 Main Street, Agawam, MA 01001 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Ashley Erin Dimauro | 25 Deer Run Road, Agawam, MA 01001 | Registered Nurse | ~ |
Lou A Fitch | 60 Mallard Circle, Agawam, MA 01001 | Notary Public Appointment | 2015-04-01 ~ 2020-03-31 |
Maryanne Catanzaro · Catanzaro,leone | 16 Channell Drive, Agawam, MA 01001 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Sunhee Hwang | 54 River Rd, Agawam, MA 01001 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-17 ~ 2021-10-31 |
Taehoon An | 58 River Rd, Agawam, MA 01001 | Nail Technician | 2020-06-17 ~ 2022-05-31 |
Ji Hye Safarik | 119 Albert St, Agawam, MA 01001 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-16 ~ 2022-02-28 |
Consuelo Ana Leblanc | 39 Hunting Lane, Agawam, MA 01001 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
Sangkeun Yi | 322 Meadow St, Agwam, MA 01001 | Nail Technician | 2020-06-12 ~ 2022-06-30 |
Kyunghee Koh | 56 River Road, Agawam, MA 01001 | Nail Technician | 2020-06-12 ~ 2021-08-31 |
Find all Licenses in zip 01001 |
City | AGAWAM |
Zip Code | 01001 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + AGAWAM |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
William H Cullen IIi | 38 Zacks Way, Agawam, MA 01001-3246 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
Patrick J Cullen Pa | 1 Shaws Cove, New London, CT 06320 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
Amanda F Votto Pa-c | 283 S Main St, Wallingford, CT 06492-4602 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
Amanda L Orszulak | 90 Greenacre Ave, Longmeadow, MA 01106-1906 | Physician Assistant | 2012-08-06 ~ 2013-05-31 |
Amanda A Cruz | 9 Jamestown Cir, Wallingford, CT 06492-2138 | Physician Assistant | 2013-06-03 ~ 2014-06-30 |
Amanda G Madkour | 51-53 Kenosia Ave, Danbury, CT 06810-2304 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
Amanda Mauck | 241 Erin Drive, Cranberry Township, PA 16066 | Physician Assistant | ~ |
Amanda J Mccabe | 189 Cornwall Hill Rd, Patterson, NY 12563-2551 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
Amanda Linn Paradiso | 90 Weathervane Dr, New Milford, CT 06776 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
Emily Amanda Durocher | 173 Rochela Dr, Southington, CT 06489-4671 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
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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).