RUSSELL W GIBSON
Physician/surgeon


Address: 245 E. 21st Street, New York, NY 10010

RUSSELL W GIBSON (Credential# 557680) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is November 30, 2007. The license expiration date date is November 30, 2008. The license status is INACTIVE.

Business Overview

RUSSELL W GIBSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.040097. The credential type is physician/surgeon. The effective date is November 30, 2007. The expiration date is November 30, 2008. The business address is 245 E. 21st Street, New York, NY 10010. The current status is inactive.

Basic Information

Licensee Name RUSSELL W GIBSON
Credential ID 557680
Credential Number 1.040097
Credential Type Physician/Surgeon
Business Address 245 E. 21st Street
New York
NY 10010
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2002-01-16
Effective Date 2007-11-30
Expiration Date 2008-11-30
Refresh Date 2009-07-08

Office Location

Street Address 245 E. 21st STREET
City NEW YORK
State NY
Zip Code 10010

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City NEW YORK
Zip Code 10010
License Type Physician/Surgeon
License Type + County Physician/Surgeon + NEW YORK

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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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