| | Physician Last Name: | Single |
| | Physician First Name: | Gordon |
| | Physician Middle Name: | W |
| | Address: | P.O.Box 636
Glens Falls, New York 12801 |
| | License Number: | 163821 |
| | License Type: | MD |
| | Year of Birth: |
1957
|
| | Effective Date: | 05/07/2004 |
| | Action Description for DOH Webpage: | Temporary surrender of license pursuant to New York State Public Health Law Section 230.13.The physician's license status is currently inactive. |
| | Misconduct Description for DOH Webpage: | This action is not disciplinary in nature. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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