LESLIE GRAVINA
Physical Therapist


Address: 22 Indian Hill Rd, Brewster, NY 10509

LESLIE GRAVINA (Credential# 690073) is licensed (Physical Therapist) with Connecticut Department of Consumer Protection. The license effective date is June 18, 2001. The license expiration date date is May 31, 2002. The license status is INACTIVE.

Business Overview

LESLIE GRAVINA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #14.004486. The credential type is physical therapist. The effective date is June 18, 2001. The expiration date is May 31, 2002. The business address is 22 Indian Hill Rd, Brewster, NY 10509. The current status is inactive.

Basic Information

Licensee Name LESLIE GRAVINA
Credential ID 690073
Credential Number 14.004486
Credential Type Physical Therapist
Business Address 22 Indian Hill Rd
Brewster
NY 10509
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1991-10-07
Effective Date 2001-06-18
Expiration Date 2002-05-31
Refresh Date 2009-07-08

Office Location

Street Address 22 INDIAN HILL RD
City BREWSTER
State NY
Zip Code 10509

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City BREWSTER
Zip Code 10509
License Type Physical Therapist
License Type + County Physical Therapist + BREWSTER

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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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