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Elise
Elise
Fallucco
Medical doctor
Child & adolescent psychiatry
Jacksonville, United States
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Florida Board of Medicine
Board Name
BOARD OF MEDICINE
Full name
Elise Fallucco
Job Title
Medical Doctor
License Number
ME109877
License Status
Clear/Active
License Issue Date
09/05/2011
License Expiry Date
31/01/2025
Source Type
Professional Profile
Florida Health Care Practitioner Data Portal
Full name
ELISE FALLUCCO
Job Title
Medical Doctor
Location
Jacksonville, FL, USA
LIC ID
108516
Current License Expiration Date
31/01/2025
Original Date
09/05/2011
Professional Rank Code
ME
Effective Date
09/05/2011
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
DUVAL
Practice Location Address Line 1
8789 San Jose Boulevard;
Practice Location Address Line 2
Suite 304
Practice Location Address City
JACKSONVILLE
Practice Location Address State
FL
Practice Location Address Zipcode
32217
Prescribing Indicator
N
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