MATTHEW C MILLER PA (Credential# 883842) 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 ACTIVE.
MATTHEW C MILLER PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002283. The credential type is physician assistant. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 750 Dunn Road, Coventry, CT 06238. The current status is active.
| Licensee Name | MATTHEW C MILLER PA |
| Credential ID | 883842 |
| Credential Number | 23.002283 |
| Credential Type | Physician Assistant |
| Business Address |
750 Dunn Road Coventry CT 06238 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2009-07-20 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-05-21 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 887745 | CSP.0046049 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-08-05 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 843291 | 70.003558 | Emergency Medical Technician | 2003-05-06 | 2008-07-09 - 2010-12-31 | INACTIVE |
| Street Address | 750 Dunn road |
| City | COVENTRY |
| State | CT |
| Zip Code | 06238 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Parul S Shah · Bidwell Spirit Shoppe | 1220 Main St, Coventry, CT 06238 | Package Store Liquor | 2020-08-02 ~ 2021-08-01 |
| Mary A Manton | 28 Armstrong Rd Unit B-9, Coventry, CT 06238 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Barbara J Dillon | 93 Alice Drive, Coventry, CT 06238 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Cody Adam Kirschbaum | 83 Daly Rd, Coventry, CT 06238 | Emergency Medical Technician | ~ |
| Stephanie A Simmons | 878 Silver St, Coventry, CT 06238 | Licensed Practical Nurse | 2020-02-01 ~ 2021-01-31 |
| Mellissa U Carroll | 349 Ripley Hill Rd, Coventry, CT 06238 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Kristin D'alfonso | 43 Windy Hill Road, Coventry, CT 06238 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Dawn Trudeau | 46 Flanders River Road, Coventry, CT 06238 | Medication Administration Certification | 2020-06-28 ~ 2022-06-27 |
| Bryan Trudel | 3505 South St., Coventry, CT 06238 | Backflow Prevention Device Tester | 2020-05-27 ~ 2023-03-31 |
| Christopher Dean | 545 Flanders Rd., Coventry, CT 06238 | Backflow Prevention Device Tester | 2020-05-27 ~ 2023-03-31 |
| Find all Licenses in zip 06238 | |||
| City | COVENTRY |
| Zip Code | 06238 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + COVENTRY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jared Matthew Miller | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Matthew A Miller | 81 Seventy Acre Road, Redding, CT 06896 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Bethany L Miller Pa | 51 Water St, Canterbury, CT 06331-1342 | Physician Assistant | 2019-06-01 ~ 2020-05-31 |
| Melissa A Miller | 174 Krystyna Lane, Jordan, NY 13080 | Physician Assistant | 2005-07-01 ~ 2006-07-31 |
| Diane Miller | 217 Kelzie Peeler Rd., Murray, KY 42071 | Physician Assistant | 2010-11-01 ~ 2011-10-31 |
| Kortney R Ribbeck Pa-c | 130 Miller Street, New Britain, CT 06053 | Physician Assistant | 2007-09-28 ~ 2008-04-30 |
| Jenna Rae Miller | 298 Moore Street, Chicopee, MA 01013 | Physician Assistant | 2020-02-19 ~ 2021-02-28 |
| Matthew T Mitchell Pa | 118 Osborne St Apt 1c, Danbury, CT 06810 | Physician Assistant | 2004-11-01 ~ 2005-10-31 |
| Matthew E. Milstein | Psc 475 Box 1315, Fpo Yokohama, 96350 | Physician Assistant | 2014-04-01 ~ 2015-03-31 |
| Matthew W. Musco Pa-c | 132 Clearfield Rd, Wethersfield, CT 06109 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
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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).