LAUREN F PETISCE
Physical Therapist


Address: 150 Nicholson St, Newington, CT 06111-4354

LAUREN F PETISCE (Credential# 934248) is licensed (Physical Therapist) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2014. The license expiration date date is April 30, 2015. The license status is INACTIVE.

Business Overview

LAUREN F PETISCE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #14.008859. The credential type is physical therapist. The effective date is May 1, 2014. The expiration date is April 30, 2015. The business address is 150 Nicholson St, Newington, CT 06111-4354. The current status is inactive.

Basic Information

Licensee Name LAUREN F PETISCE
Credential ID 934248
Credential Number 14.008859
Credential Type Physical Therapist
Business Address 150 Nicholson St
Newington
CT 06111-4354
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2010-07-26
Effective Date 2014-05-01
Expiration Date 2015-04-30
Refresh Date 2015-08-05

Office Location

Street Address 150 NICHOLSON ST
City NEWINGTON
State CT
Zip Code 06111-4354

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City NEWINGTON
Zip Code 06111
License Type Physical Therapist
License Type + County Physical Therapist + NEWINGTON

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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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