JAMES D PROVENZANO MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036063923

License Status

INACTIVE

Business

First Name

JAMES D

Last Name

PROVENZANO

Suffix

Business Name

JAMES D PROVENZANO MD

Original Issue Date

02/22/1982

Effective Date

02/22/1982

Expiration Date

07/31/1987

City

NAPLES

State

Zip

33942

County

FLORIDA

Ever Disciplined

LastModifiedDate

09/20/2006