License holder summary

PETER PROVOSTY TAILLAC is a Physician - Physician & Surgeon licensed to practice in Utah. The address on file for PETER PROVOSTY TAILLAC is SALT LAKE CITY, UT 84132. This licensed professional license is current. The license was granted 10/28/1994 and expired on 01/31/2016.

Utah

Division of Occupational and Professional Licensing

PETER PROVOSTY TAILLAC
Physician - Physician & Surgeon
License number
279025-1205
Date granted
10/28/1994
Date expires
01/31/2016
Class
Physician - Physician & Surgeon
Status
Active
Address
SALT LAKE CITY, UT 84132
utahlicensing.org
ID 29932044
LAST UPDATED 2026-04-12 15:40:53 UTC

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