DONALD STEVEN PROVENZANO Podiatrist License verification

Business Entity

INACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016003070

License Status

INACTIVE

Business

First Name

DONALD STEVEN

Last Name

PROVENZANO

Business Name

DONALD STEVEN PROVENZANO

Original Issue Date

06/27/1979

Effective Date

06/27/1979

Expiration Date

01/31/1985

City

GADSDEN

State

Zip

35901

County

ALABAMA

Ever Disciplined

LastModifiedDate

09/25/2006