LISA MARIE PROVENZA DC Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED CHIROPRACTIC PHYSICIAN

License Number

038009194

License Status

INACTIVE

Business

First Name

LISA

Middle

MARIE

Last Name

PROVENZA

Suffix

Business Name

LISA MARIE PROVENZA DC

Original Issue Date

09/28/2000

Effective Date

09/28/2000

Expiration Date

07/31/2002

City

CANFIELD

State

Zip

44406

County

OHIO

Ever Disciplined

LastModifiedDate

10/09/2006