COURTNEY M FANKHANEL PA (Credential# 743974) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is APPROVED.
COURTNEY M FANKHANEL PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002225. The credential type is physician assistant. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 10 Twin Pines Drive, Wallingford, CT 06492. The current status is approved.
| Licensee Name | COURTNEY M FANKHANEL PA |
| Credential ID | 743974 |
| Credential Number | 23.002225 |
| Credential Type | Physician Assistant |
| Business Address |
10 Twin Pines Drive Wallingford CT 06492 |
| Business Type | INDIVIDUAL |
| Status | APPROVED - CURRENT |
| Active | 1 |
| Issue Date | 2009-01-13 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 524537 | CSP.0045090 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-02-03 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 845478 | 70.005745 | Emergency Medical Technician | 2005-03-16 | 2006-08-14 - 2008-06-30 | INACTIVE |
| 822149 | 69.004726 | Emergency Medical Responder | 2004-09-23 | 2004-09-23 - 2006-06-30 | INACTIVE |
| Street Address | 10 Twin Pines Drive |
| City | Wallingford |
| State | CT |
| Zip Code | 06492 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrea Zola | 53 Alison Ave., Wallingford, CT 06492 | Esthetician | ~ |
| Kyungok Choi | 90 Ward St, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Giang Nguyen | 45 Country Club Lane, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-11-30 |
| Lc Artistry | 207 North Colony Road, Wallingford, CT 06492 | Esthetician | ~ |
| Katie Lee | 20 Angela Dr, Wallingford, CT 06492 | Paramedic | 2020-09-01 ~ 2021-08-31 |
| Vinny's Deli | 567 Center St, Wallingford, CT 06492 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Michele Ruggiero | 26 Leigus Road, Wallingford, CT 06492 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Dianna K Ball | 104 Simpson Ave, Wallingford, CT 06492 | Speech and Language Pathologist | 2020-08-01 ~ 2021-07-31 |
| Ann Marie Richardson | 20 Mohawk Drive, Wallingford, CT 06492 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Joann Hummel | 60 Deer Run Road, Wallingford, CT 06492 | Medication Administration Certification | 2018-08-21 ~ 2020-08-20 |
| Find all Licenses in zip 06492 | |||
| City | Wallingford |
| Zip Code | 06492 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + Wallingford |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Courtney Nicole Enos | 916 1/2 4th St Ne, Byron, MN 55920-1530 | Physician Assistant | ~ |
| Courtney Christine Marquardt | 1 Dicardee Dr, Enfield, CT 06082-1905 | Physician Assistant | ~ |
| Courtney R Whittle | 73 Perry Rd, Bristol, CT 06010-7812 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Courtney Adair Chenault | 110 Lismore Ave, Glenside, PA 19038-4011 | Physician Assistant | ~ |
| Courtney Sherman | 18 John Ct., Randolph, NJ 07869 | Physician Assistant | 2004-01-28 ~ 2004-09-30 |
| Courtney Wagner Peerless | 52 Charlesgate E Apt 155, Boston, MA 02215-3624 | Physician Assistant | 2018-12-01 ~ 2019-11-30 |
| Courtney R Hollingsworth | 428 Country Walk, Amherst, OH 44001-2635 | Physician Assistant | 2016-10-01 ~ 2017-09-30 |
| Heidi A Courtney | 108 Circle Drive, Chicopee, MA 01020 | Physician Assistant | 1999-10-28 ~ 2000-07-31 |
| Courtney Elizabeth Peck | 365 Montauk Ave, New London, CT 06320-4700 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Courtney Beth Stewart | 1751 Earl Core Rd., Morgantown, WV 26505 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
Please comment or provide details below to improve the information on COURTNEY M FANKHANEL 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).