MICHAEL VINCENT TALLARICO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058221

License Status

CANCELLED

Business

Title

First Name

MICHAEL

Middle

VINCENT

Last Name

TALLARICO

Business Name

MICHAEL VINCENT TALLARICO MD

Original Issue Date

06/22/2010

Effective Date

06/22/2010

Expiration Date

06/21/2013

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/11/2010