STACY S ADIL (Credential# 892831) 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.
STACY S ADIL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002313. The credential type is physician assistant. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 84 Hawthorne Ave, Hamden, CT 06517-1825. The current status is active.
| Licensee Name | STACY S ADIL |
| Credential ID | 892831 |
| Credential Number | 23.002313 |
| Credential Type | Physician Assistant |
| Business Address |
84 Hawthorne Ave Hamden CT 06517-1825 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2009-09-03 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-16 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 896307 | CSP.0046745 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-10-09 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 84 HAWTHORNE AVE |
| City | HAMDEN |
| State | CT |
| Zip Code | 06517-1825 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Frank J Tamarkin | 84 Hawthorne Ave, Hamden, CT 06517 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nikole N Baker | 108 Hawthorne Ave, Hamden, CT 06517-1825 | Emergency Medical Technician | 2018-08-02 ~ 2020-10-01 |
| Bruce Duncan Perry | 76 Hawthorne Ave, Hamden, CT 06517-1825 | Physician/surgeon | 1986-11-14 ~ 1988-05-31 |
| Luke H Mattison | 60 Hawthorne Ave, Hamden, CT 06517-1825 | Chiropractor | 2012-06-01 ~ 2013-05-31 |
| Thomas M O'neill | 96 Hawthorne Ave, Hamden, CT 06517-1825 | Public Service Technician - Telephone | 2015-10-01 ~ 2016-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Timothy J Freer | 33 Norris Street, Hamden, CT 06517 | Physical Therapist | 2020-09-01 ~ 2021-08-31 |
| Juan Ignacio Zurita-castilla | 43 Merritt St, Hamden, CT 06517 | Master's Level Social Worker - Temporary Permit | 2020-06-25 ~ 2020-09-13 |
| Elizabeth Alberico | 58 Hesse Road, Hamden, CT 06517 | Notary Public Appointment | 2020-06-01 ~ 2025-05-31 |
| Stephen M Grossman | 17 Greenway St, Hamden, CT 06517 | Architect | 2020-08-01 ~ 2021-07-31 |
| James E Laposta Jr | 66 Laurel Road, Hamden, CT 06517 | Architect | 2020-08-01 ~ 2021-07-31 |
| Judith M Rothstein | 11 Dadio Road, Hamden, CT 06517 | Licensed Alcohol and Drug Counselor | 2020-04-01 ~ 2021-03-31 |
| Keleann T Tamaki | 165 Ridge Road, Hamden, CT 06517 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Robin L Esposito | 191 Thornton St, Hamden, CT 06517 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Michele R Abrams | 114 Wakefield St, Hamden, CT 06517 | Audiologist | 2020-09-01 ~ 2021-08-31 |
| Catherine E Tesluk | 215 Hartford Tpke, Hamden, CT 06517 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06517 | |||
| City | HAMDEN |
| Zip Code | 06517 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + HAMDEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Stacy Anne Henderson Pa | 41 Germantown Rd Ste 101, Danbury, CT 06810-4087 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Stacy Fuller Baecker Pa-c | 28 Magnolia Ave, Norwalk, CT 06850-3631 | Physician Assistant | 2010-09-01 ~ 2011-08-31 |
| Stacy E Shimp | 1673 Ludwell Drive, Ambler, PA 19002 | Physician Assistant | 2019-12-01 ~ 2020-11-30 |
| Stacy Holtz Pa | 245 Jeremy Swamp Road, Southbury, CT 06488 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Stacy Alex Robinson | 8246 Azur Coast Boulevard, Lake Worth, FL 33467 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Adil Javed Md | 129 York St#3k, New Haven, CT 06511 | Physician/surgeon | 2003-03-11 ~ 2004-03-31 |
| Adil Salam Md | 44 Crawford Rd, Westport, CT 06880 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Adil S Bhutta | 380 Mather Street, Hamden, CT 06514 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Adil M Choudhary | P.o.box 126469, Fort Worth, TX 76126-6469 | Physician/surgeon | 2011-01-01 ~ 2011-12-31 |
| Stacy L James | 84 Roosevelt Ave. Ext., Preston, CT 06365 | Physical Therapist Assistant | 2019-10-01 ~ 2020-09-30 |
Please comment or provide details below to improve the information on STACY S ADIL.
| 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).