JAVIER ANDRES TELLAGORRY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036141173

License Status

NOT RENEWED

Business

Title

First Name

JAVIER

Middle

ANDRES

Last Name

TELLAGORRY

Business Name

JAVIER ANDRES TELLAGORRY MD

Original Issue Date

07/08/2016

Effective Date

05/18/2020

Expiration Date

07/31/2023

City

MARION

State

Zip

62959

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

11/30/2023