GREGORY L BORIS DO (Credential# 558483) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is ACTIVE.
GREGORY L BORIS DO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.040900-DO. The credential type is physician/surgeon. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is Griffin Hospital / Dept of Emer Med, Derby, CT 06418. The current status is active.
| Licensee Name | GREGORY L BORIS DO |
| Credential ID | 558483 |
| Credential Number | 1.040900-DO |
| Credential Type | Physician/Surgeon |
| Credential SubCategory | DO |
| Business Address |
Griffin Hospital / Dept of Emer Med Derby CT 06418 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2002-10-17 |
| Effective Date | 2020-08-01 |
| Expiration Date | 2021-07-31 |
| Refresh Date | 2020-05-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 327253 | CSP.0032945 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2002-11-14 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | GRIFFIN HOSPITAL / DEPT OF EMER MED |
| City | DERBY |
| State | CT |
| Zip Code | 06418 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Debra A Montini | 8 Academy Hill Ext, Derby, CT 06418 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Laura M Boanno | 131 Marshall La, Derby, CT 06418 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Danyun Chen | 49 Pershing Dr., Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Fan Geng | Shoprite Shopping Center, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Danni Xu | Shoprite Shopping Center49 Pershing Dr, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Yao Zhang | Shoprite Shopping Center 49 Pershing Dr, Derby, CT 06418 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Phillip N Burke | 3 Camptown St, Derby, CT 06418 | Emergency Medical Technician | 2017-06-07 ~ 2020-06-30 |
| Diane A Rosner | 229 Shagbark Drive, Derby, CT 06418 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Pamela C Lavelle | 194 Minerva St, Derby, CT 06418 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Grade A Market - Derby LLC | 49 Pershing Dr, Derby, CT 06418 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06418 | |||
| City | DERBY |
| Zip Code | 06418 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + DERBY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Boris Goralnik | 2661 W 2nd St Apt 5c, Brooklyn, NY 11223-6360 | Physician/surgeon | 2011-11-01 ~ 2012-10-31 |
| Boris Naprta | 31 A Harold Road, Farmington, CT 06032 | Physician/surgeon | ~ 1998-07-31 |
| Boris M Astrachan | Professor Head Uic, Chicago, IL 60612 | Physician/surgeon | 1995-10-23 ~ 1996-12-31 |
| Gayle L Boris | 300 East 75th St, New York, NY 10021 | Physician/surgeon | 2001-01-04 ~ 2002-02-28 |
| Boris Krikun | 66-36 Yellowstone, Forest Hills, NY 11375 | Physician/surgeon | ~ 2000-02-29 |
| Boris Sachakov | 3133 Brighton 7th St Apt 3i, Brooklyn, NY 11235-6506 | Physician/surgeon | 2012-11-01 ~ 2013-08-06 |
| Boris Konnikow Md | Day Kimball Hospital, Putnam, CT 06260-1868 | Physician/surgeon | 1999-01-19 ~ 2000-02-29 |
| Boris Medarov | 165 Falls Terrace, Oakville, CT 06779 | Physician/surgeon | 2008-07-22 ~ 2009-08-31 |
| Boris Usherenko | 480 Bedford Road, Chappaqua, NY 10514 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Boris Mayzler | 70 Mill River Street, Stamford, CT 06902 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
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| 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).