JAMES D PROVENZANO MD - Medical Doctor License in Florida | # 036063923

JAMES D PROVENZANO MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036063923

License Status

INACTIVE

Business

N

First Name

JAMES D

Last Name

PROVENZANO

Suffix

MD

Business Name

JAMES D PROVENZANO MD

Original Issue Date

02/22/1982

Effective Date

02/22/1982

Expiration Date

07/31/1987

State

FL

Ever Disciplined

N

LastModifiedDate

09/20/2006