TERRY W TALLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

NOT RENEWED

Business

First Name

TERRY W

Last Name

TALLEY

Suffix

Business Name

TERRY W TALLEY MD

Original Issue Date

10/09/1996

Effective Date

07/24/2014

Expiration Date

07/31/2017

City

HARRISBURG

State

Zip

62946

County

SALINE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017