AGNIESZKA FORMEJSTER
Physical Therapist Assistant


Address: 61 Taylor St., Chicopee, MA 01020

AGNIESZKA FORMEJSTER (Credential# 786331) is licensed (Physical Therapist Assistant) with Connecticut Department of Consumer Protection. The license effective date is February 7, 2001. The license expiration date date is November 1, 2006. The license status is INACTIVE.

Business Overview

AGNIESZKA FORMEJSTER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #63.000189. The credential type is physical therapist assistant. The effective date is February 7, 2001. The expiration date is November 1, 2006. The business address is 61 Taylor St., Chicopee, MA 01020. The current status is inactive.

Basic Information

Licensee Name AGNIESZKA FORMEJSTER
Credential ID 786331
Credential Number 63.000189
Credential Type Physical Therapist Assistant
Business Address 61 Taylor St.
Chicopee
MA 01020
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2001-02-07
Effective Date 2001-02-07
Expiration Date 2006-11-01
Refresh Date 2009-07-08

Office Location

Street Address 61 Taylor St.
City Chicopee
State MA
Zip Code 01020

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Donna M Rowe-scott 126 Labelle Dr, Chicopee, MA 01020 Registered Nurse 2020-09-01 ~ 2021-08-31
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Theresa L Williams 142 Casey Drive, Chicopee, MA 01020 Registered Nurse 2020-06-01 ~ 2021-05-31
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Competitor

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City Chicopee
Zip Code 01020
License Type Physical Therapist Assistant
License Type + County Physical Therapist Assistant + Chicopee

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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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