JAMES E PROVO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036085207

License Status

NOT RENEWED

Business

First Name

JAMES E

Last Name

PROVO

Suffix

Business Name

JAMES E PROVO MD

Original Issue Date

08/24/1992

Effective Date

08/24/1992

Expiration Date

07/31/2002

City

FORT LAUDERDALE

State

Zip

33324

County

FLORIDA

Ever Disciplined

LastModifiedDate

10/09/2006