BRIAN DAVID TALLERICO DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035985

License Status

EXPIRED

Business

Title

First Name

BRIAN DAVID

Last Name

TALLERICO

Business Name

BRIAN DAVID TALLERICO DO

Original Issue Date

05/14/1997

Effective Date

05/14/1997

Expiration Date

06/19/1998

City

OLYMPIA FLDS

State

Zip

60461

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006