DEBORAH W PROVENCE Speech-Language Pathologist License verification

Business Entity

INACTIVE

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146004436

License Status

INACTIVE

Business

First Name

DEBORAH W

Last Name

PROVENCE

Business Name

DEBORAH W PROVENCE

Original Issue Date

08/22/1994

Effective Date

10/29/2021

Expiration Date

10/31/2023

City

DWIGHT

State

Zip

60420

Ever Disciplined

LastModifiedDate

10/27/2023