GREGORY J FAUST (Credential# 553479) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2014. The license expiration date date is March 31, 2015. The license status is INACTIVE.
GREGORY J FAUST is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.035886. The credential type is physician/surgeon. The effective date is April 1, 2014. The expiration date is March 31, 2015. The business address is 3640 Main St Ste 205, Springfield, MA 01107-1139. The current status is inactive.
| Licensee Name | GREGORY J FAUST |
| Credential ID | 553479 |
| Credential Number | 1.035886 |
| Credential Type | Physician/Surgeon |
| Business Address |
3640 Main St Ste 205 Springfield MA 01107-1139 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1997-03-21 |
| Effective Date | 2014-04-01 |
| Expiration Date | 2015-03-31 |
| Refresh Date | 2015-07-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1070181 | CSP.0052395 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2012-05-14 | 2013-03-01 - 2015-02-28 | INACTIVE |
| Street Address | 3640 MAIN ST STE 205 |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01107-1139 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brian K Bredvik | 3640 Main St Ste 205, Springfield, MA 01107-1139 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Mark A Jackowitz | 3640 Main St Ste 205, Springfield, MA 01107-1139 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Philip Moraitis | 3640 Main St Ste 205, Springfield, MA 01107-1139 | Physician/surgeon | 2016-05-01 ~ 2017-04-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan D Glover | 3640 Main Street, Springfield, MA 01107-1139 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Phillip S Kick | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | 2016-04-01 ~ 2017-03-31 |
| William C Tran | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | 2014-08-01 ~ 2015-07-31 |
| Raphael J De Lima | 3640 Main Street, Springfield, MA 01107-1139 | Physician/surgeon | 2008-10-14 ~ 2009-10-31 |
| Mohammad R Mostafavi | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | ~ |
| Donald J Sonn | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | ~ |
| Alexander M. Berry | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lauren Elizabeth Marshall | 945 Armory St, Springfield, MA 01107 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Jennifer L Fish | 367 Union Street, Springfield, MA 01107 | Hairdresser/cosmetician | ~ |
| Joseph Pagan | 59 Rowland Street, Springfield, MA 01107 | Medication Administration Certification | 2020-04-20 ~ 2022-04-19 |
| Daniel Laguerre | 382 Springfield St, Springfield, MA 01107 | Crane Operator | ~ |
| Kamal Kant Kalia | 2 Medical Center Drive, Springfield, MA 01107 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Bushee Enterprises LLC | Po Box 1196, Southwick, MA 01107 | Home Improvement Contractor | 2015-12-01 ~ 2016-11-30 |
| B Lopez | 165 Prospect Street, Springfield, MA 01107 | Notary Public Appointment | 2011-10-01 ~ 2016-09-30 |
| Beth C Mcinerny | 260 Ware Road, Belchertown, MA 01107 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Jorge Enrique Rivera | 20 Narragansett Street, Springfield, MA 01107 | Professional Counselor | 2019-10-01 ~ 2020-09-30 |
| Rachael Hynds-decoteau | 22 Candice Cir, Springfield, MA 01107 | Controlled Substance Registration for Practitioner | 2019-09-19 ~ 2021-02-28 |
| Find all Licenses in zip 01107 | |||
| City | SPRINGFIELD |
| Zip Code | 01107 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + SPRINGFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Phyllis L Faust | 520 West 110th St, New York, NY 10025 | Physician/surgeon | ~ |
| Thomas Wilson Faust | 539 Orange St Apt 3, New Haven, CT 06511-3834 | Physician/surgeon | 1985-07-01 ~ 1986-08-31 |
| James A Bowden | 110 Faust Ford, Gate City, VA 24251 | Physician/surgeon | 2007-06-11 ~ 2008-07-31 |
| Gregory M Faust | 7 Stirling Ct, Middletown, CT 06457-1630 | Emergency Medical Technician | 2020-01-01 ~ 2022-12-31 |
| Gregory Faust | 3 Skyview Drive, New Milfors, CT 06776 | Medication Administration Certification | 2019-05-29 ~ 2021-05-29 |
| Thomas Faust Cpa | 174 Coldbrook Ct, Lafayette, IN 47909-3802 | Certified Public Accountant Firm Permit | 2020-01-01 ~ 2020-12-31 |
| Tramont Faust | 19 Heather Drive, Wethersfield, CT 06109 | Certified Public Accountant Firm Permit | 1985-01-01 ~ 1985-12-31 |
| Gregory C Cadman | 7 Lighthouse Ln, Old Greenwich, CT 06870-2310 | Physician/surgeon | ~ |
| Gregory A Rutkowski Md | 44 Canterbury Rd, Berlin, CT 06037-3706 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Gregory H. Adkisson | 68 S Service Rd Ste 350, Melville, NY 11747-2358 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
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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).