Utah
Division of Occupational and Professional Licensing
DENISE PROVOST
Physician - Physician & Surgeon
License number
349667-1205
Date granted
11/04/1997
Date expires
01/31/2004
Class
Physician - Physician & Surgeon
Status
Expired
Address
FOSTER CITY, CA 94404
utahlicensing.org
ID 29922505
LAST UPDATED 2024-02-19 08:43:54 UTC
LAST UPDATED 2024-02-19 08:43:54 UTC
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