BRIAN DAVID TALLERICO DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144262

License Status

NOT RENEWED

Business

Title

First Name

BRIAN DAVID

Last Name

TALLERICO

Business Name

BRIAN DAVID TALLERICO DO

Original Issue Date

09/01/2017

Effective Date

09/01/2017

Expiration Date

09/30/2020

City

ETNA

State

Zip

83118

Ever Disciplined

LastModifiedDate

01/14/2021