THERESA FRANCINE PROVINCE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001354

License Status

NOT RENEWED

Business

First Name

THERESA

Middle

FRANCINE

Last Name

PROVINCE

Business Name

THERESA FRANCINE PROVINCE

Original Issue Date

02/10/2000

Effective Date

02/10/2000

Expiration Date

03/01/2002

City

BILOXI

State

Zip

39532

County

MISSISSIPPI

Ever Disciplined

LastModifiedDate

10/09/2006