GREGORY J GALLIVAN
Physician/surgeon


Address: 108 White Oaks Dr Ste 7, Longmeadow, MA 01106-1741

GREGORY J GALLIVAN (Credential# 540026) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2016. The license expiration date date is April 30, 2017. The license status is INACTIVE.

Business Overview

GREGORY J GALLIVAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.011528. The credential type is physician/surgeon. The effective date is May 1, 2016. The expiration date is April 30, 2017. The business address is 108 White Oaks Dr Ste 7, Longmeadow, MA 01106-1741. The current status is inactive.

Basic Information

Licensee Name GREGORY J GALLIVAN
Credential ID 540026
Credential Number 1.011528
Credential Type Physician/Surgeon
Business Address 108 White Oaks Dr Ste 7
Longmeadow
MA 01106-1741
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1963-10-29
Effective Date 2016-05-01
Expiration Date 2017-04-30
Refresh Date 2017-08-03

Office Location

Street Address 108 WHITE OAKS DR STE 7
City LONGMEADOW
State MA
Zip Code 01106-1741

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Krystyna Olczuk 158 Tanglewood Dr, Longmeadow, MA 01106 Registered Nurse 2020-08-01 ~ 2021-07-31
Susan M Neville 43 Lincoln Road, Longmeadow, MA 01106 Registered Nurse 2020-07-01 ~ 2021-06-30
Kate E Schoenberger 91 Williston Dr, Longmeadow, MA 01106 Paramedic 2020-09-01 ~ 2021-08-31
Bryant E Ostrander 52 Whitmun Road, Longmeadow, MA 01106 Notary Public Appointment 2020-10-01 ~ 2025-09-30
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City LONGMEADOW
Zip Code 01106
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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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