MEREDITH PRICE PROVOST MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036140969

License Status

ACTIVE

Business

Title

First Name

MEREDITH

Middle

PRICE

Last Name

PROVOST

Business Name

MEREDITH PRICE PROVOST MD

Original Issue Date

06/17/2016

Effective Date

07/15/2023

Expiration Date

07/31/2026

City

INDIANAPOLIS

State

Zip

46280

Ever Disciplined

LastModifiedDate

07/21/2023