NIKOLE J HENDERSON PA-C (Credential# 952836) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
NIKOLE J HENDERSON PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0048939. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 38 Gallup Ln, Waterford, CT 06385-2242. The current status is active.
| Licensee Name | NIKOLE J HENDERSON PA-C |
| Credential ID | 952836 |
| Credential Number | CSP.0048939 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
38 Gallup Ln Waterford CT 06385-2242 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2010-09-15 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 948017 | 23.002450 | Physician Assistant | 2010-09-08 | 2019-10-01 - 2020-09-30 | ACTIVE |
| 845101 | 70.005368 | Emergency Medical Technician | 2004-09-28 | 2008-03-10 - 2010-01-01 | INACTIVE |
| Street Address | 38 GALLUP LN |
| City | WATERFORD |
| State | CT |
| Zip Code | 06385-2242 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Howard Christopher Rosas | 40 Ridgewood Ave, Waterford, CT 06385 | Chiropractor | 2020-07-01 ~ 2021-06-30 |
| Vincent F Donato | 26 Wild Rose Avenue, Waterford, CT 06385 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Mark A Herter | 51 Quarry Rd, Waterford, CT 06385 | Architect | 2020-08-01 ~ 2021-07-31 |
| Pamela A Manke | 54 Rope Ferry Rd., Waterford, CT 06385 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Carol Winslow | 18 Myrock Ave, Waterford, CT 06385 | Marital and Family Therapist | 2020-09-01 ~ 2021-08-31 |
| Donna M Rivero · Knupp | 3 Ridgewood Ave, Waterford, CT 06385 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Margaret A Goldschneider · Chapman | 3 High Ridge Drive, Waterford, CT 06385 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Frank R Dellacono Md | 201 Boston Post Road, Waterford, CT 06385 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mathew H Tellier | 25 Locust Ct., Waterford, CT 06385 | Backflow Prevention Device Tester | 2020-06-18 ~ 2023-03-31 |
| Renata Kamburi | 16 Marilyn Road, Waterford, CT 06385 | Esthetician | 2020-06-20 ~ 2021-12-31 |
| Find all Licenses in zip 06385 | |||
| City | WATERFORD |
| Zip Code | 06385 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WATERFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lee W Henderson Md | Po Box 37, South Kent, CT 06785 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Sharon Henderson Od | Lenscrafters, Avon, CT 06001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hilliard Spitz Md | 17 Henderson Rd, New London, CT 06320 | Controlled Substance Registration for Practitioner | 1993-01-06 ~ 1995-02-01 |
| Pamela R Henderson | 299 Carew St Ste 400, Springfield, MA 01104-2361 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Brooke F Henderson Pa-c | 24 Ash Dr, Gales Ferry, CT 06335-1702 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Wenting Hou Aprn | 20 Henderson Dr., Avon, CT 06001 | Controlled Substance Registration for Practitioner | 2011-05-05 ~ 2013-02-28 |
| Shasta E Henderson | 6 Barnett Street, New Haven, CT 06515 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Toni L Henderson | 234 Sherman Avenue, Meriden, CT 06450 | Controlled Substance Registration for Practitioner | 1995-10-25 ~ 1997-02-28 |
| Kristen F Henderson | 559 Coventry Drive, Nutley, NJ 07110 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Theresa Chong Od | 30 Strada Bi Villaggio, Henderson, NV 89011 | Controlled Substance Registration for Practitioner | 2009-07-15 ~ 2011-02-28 |
Please comment or provide details below to improve the information on NIKOLE J HENDERSON PA-C.
| 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).