CYNTHIA ANN PROVOST Speech-Language Pathologist License verification

Business Entity

NOT RENEWED

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146005338

License Status

NOT RENEWED

Business

First Name

CYNTHIA ANN

Last Name

PROVOST

Business Name

CYNTHIA ANN PROVOST

Original Issue Date

09/10/1997

Effective Date

10/18/2019

Expiration Date

01/31/2022

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

05/18/2022