BRIAN ADDIS COSTELLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036134179

License Status

NOT RENEWED

Business

Title

First Name

BRIAN

Middle

ADDIS

Last Name

COSTELLO

Business Name

BRIAN ADDIS COSTELLO MD

Original Issue Date

11/15/2013

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

ROCHESTER

State

Zip

55902

County

MINNESOTA

Ever Disciplined

LastModifiedDate

01/14/2021