LISA M WAGNER (Credential# 786999) is licensed (Physical Therapist Assistant) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2020. The license expiration date date is December 31, 2020. The license status is ACTIVE.
LISA M WAGNER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #63.000858. The credential type is physical therapist assistant. The effective date is January 1, 2020. The expiration date is December 31, 2020. The business address is 24 Putnam Street, Manchester, CT 06040. The current status is active.
| Licensee Name | LISA M WAGNER |
| Credential ID | 786999 |
| Credential Number | 63.000858 |
| Credential Type | Physical Therapist Assistant |
| Business Address |
24 Putnam Street Manchester CT 06040 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2005-06-14 |
| Effective Date | 2020-01-01 |
| Expiration Date | 2020-12-31 |
| Refresh Date | 2019-12-03 |
| Street Address | 24 PUTNAM STREET |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06040 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mary Fosuah Nketia | 61 Cougar Drive, Manchester, CT 06040 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| New Seasons Inc. | 164 East Center Street, Manchester, CT 06040 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Kaylen Lam | 60 Chlistone Lane, Manchester, CT 06040 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Matilde Altamirano | 415 Gardner Street, Manchester, CT 06040 | Nail Technician | 2020-06-27 ~ 2022-04-30 |
| Meilan Meilan Chen | 174 Middle Tpke, Manchester, CT 06040 | Nail Technician | ~ |
| Prince Acheampong | 32 Bigelow Street, Manchester, CT 06040 | Notary Public Appointment | ~ |
| Erin C Boyle | 470 Porter Street, Manchester, CT 06040 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dejone Mitchell | 64 Ruby Dr Apt. P, Manchester, CT 06040 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Andrea H Clifford | 116 Longview Drive, Manchester, CT 06040 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Tabia Thornton-bey | 103 Walek Farms Road, Manchester, CT 06040 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06040 | |||
| City | MANCHESTER |
| Zip Code | 06040 |
| License Type | Physical Therapist Assistant |
| License Type + County | Physical Therapist Assistant + MANCHESTER |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marilyn C Wagner | 1807 Cornett Pl, Kissimmee, FL 34741-2005 | Physical Therapist Assistant | 2014-10-01 ~ 2015-09-30 |
| Lisa A Costanzo | Po. Box 825, Georgetown, MA 01833 | Physical Therapist Assistant | ~ 2006-11-01 |
| Lisa L Burns | 3 Madison Dr, Newtown, CT 06470-2014 | Physical Therapist Assistant | 2020-02-01 ~ 2021-01-31 |
| Lisa A Wotring | 56 Middle Rd, Preston, CT 06365-8220 | Physical Therapist Assistant | 2020-04-01 ~ 2021-03-31 |
| Lisa G Patterson | 14 Oak Park Dr., Centralia, IL 62801 | Physical Therapist Assistant | 2003-02-26 ~ 2006-11-01 |
| Lisa M Weik | 205 West St, Lakeside, CT 06758-5804 | Physical Therapist Assistant | 2019-12-01 ~ 2020-11-30 |
| Lisa M Franco | 60 Hemlock St, Manchester, CT 06040-4016 | Physical Therapist Assistant | 2019-10-01 ~ 2020-09-30 |
| Lisa D Fiasconaro | 4 Daisy Ln, Ellington, CT 06029-3240 | Physical Therapist Assistant | 2020-01-01 ~ 2020-12-31 |
| Lisa A O'brien | 32 Sunnybrook Dr, Manchester, CT 06040-6622 | Physical Therapist Assistant | 2020-06-01 ~ 2021-05-31 |
| Lisa M Mccormick | 137 N Brook St, Hampton, CT 06247-3600 | Physical Therapist Assistant | 2020-06-01 ~ 2021-05-31 |
Please comment or provide details below to improve the information on LISA M WAGNER.
| 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).