KATIE M ROACH (Credential# 952695) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
KATIE M ROACH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002468. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 3 David Drive, Simsbury, CT 06070. The current status is active.
| Licensee Name | KATIE M ROACH |
| Credential ID | 952695 |
| Credential Number | 23.002468 |
| Credential Type | Physician Assistant |
| Business Address |
3 David Drive Simsbury CT 06070 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2010-09-15 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-04-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 968896 | CSP.0049061 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2010-10-06 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 846994 | 70.007261 | Emergency Medical Technician | 2006-06-20 | 2008-05-15 - 2010-03-31 | INACTIVE |
| Street Address | 3 David Drive |
| City | Simsbury |
| State | CT |
| Zip Code | 06070 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Henry Withers | 571 Hopmeadow St, Simsbury, CT 06070 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Nancy W Flanagan | 9 Carver Circle, Simsbury, CT 06070 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Catharina A Bates | 12 East View Dr., Simsbury, CT 06070 | Real Estate Salesperson | 2020-06-25 ~ 2021-05-31 |
| Faith E Preato | 25 Squadron Line Rd, Simsbury, CT 06070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Diane Bragoni | 542 Hopmeadow Street, #128, Simsbury, CT 06070 | Architect | 2020-08-01 ~ 2021-07-31 |
| Virginia S Durst · Banks | 20 Woodcliff Drive, Simsbury, CT 06070 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Caitlin M Cornier | 18 Saxton Brook Drive, Simsbury, CT 06070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Nancy L Alleva · Maule | 1079 Hopmeadow St, Simsbury, CT 06070 | Respiratory Care Practitioner | 2020-09-01 ~ 2021-08-31 |
| Stephen R Birghenti · Simsbury Inn | 397 Hopmeadow St, Simsbury, CT 06070 | Hotel Liquor (50000 Or More Population) | 2019-08-14 ~ 2020-12-13 |
| Deborah L Poniatowski · Blase | 35 Munnisunk Dr, Simsbury, CT 06070 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06070 | |||
| City | Simsbury |
| Zip Code | 06070 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + Simsbury |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Philip M. Roach Pa | 3 David Dr, Simsbury, CT 06070-3043 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Katie S Kwok Pa-c | 177 Judson Rd, Fairfield, CT 06824 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Katie L Merithew | 10 Phelps Dr, Hamden, CT 06514 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Katie A Coppola | 288 Haddam Quarter Rd, Durham, CT 06422-1618 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Katie J Arey | 9 Cobblestone Dr, Broad Brook, CT 06016-1200 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Katie Lynn Anderson | 15 Wiemes Ct, Waterford, CT 06385 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Katie Lynn Tichenor | 2 Ross Passway, Morris, CT 06763-1300 | Physician Assistant | 2016-11-01 ~ 2017-10-31 |
| Katie Lynn Scott | 5717 Pacific Center Blvd, San Diego, CA 92121-4250 | Physician Assistant | 2020-01-01 ~ 2020-12-31 |
| Kelly J Roach | 13 Wildflower Dr, Seekonk, MA 02771-1703 | Physical Therapist Assistant | 2019-12-01 ~ 2020-11-30 |
| Brian John Roach | 50 Eastern Pkwy, Milford, CT 06460-5001 | Physical Therapist Assistant | 2020-01-01 ~ 2020-12-31 |
Please comment or provide details below to improve the information on KATIE M ROACH.
| 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).