| Name: | WALLACE E. GONSALVES, JR., D.O., INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 06 Sep 1996 (28 years ago) |
| Date of Dissolution: | 07 Nov 2003 (21 years ago) |
| Date of Status Change: | 07 Nov 2003 (21 years ago) |
| Identification Number: | 000091264 |
| ZIP code: | 02905 |
| County: | Providence County |
| Principal Address: | 1596 BROAD STREET, CRANSTON, RI, 02905, USA |
| Purpose: | THE PRACTICE OF OSTEOPATHIC MEDICINE. |
| Name | Role | Address |
|---|---|---|
| DINO A. BROSCO | Agent | 312 SOUTH MAIN STREET, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| WALLACE E GONSALVES JR DO | PRESIDENT | 1596 BROAD STREET CRANSTON, RI 02905 USA |
Date of last update: 08 Oct 2024
Sources: Rhode Island Department of State
