RANDALL JAMES PROVICK DC Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED CHIROPRACTIC PHYSICIAN

License Number

038007465

License Status

NOT RENEWED

Business

First Name

RANDALL JAMES

Last Name

PROVICK

Suffix

Business Name

RANDALL JAMES PROVICK DC

Original Issue Date

04/18/1994

Effective Date

08/01/2005

Expiration Date

07/31/2008

City

SALIDA

State

Zip

81201

Ever Disciplined

LastModifiedDate

11/06/2008