AUGUSTINE PROVENCIO
Medical Practice in Pinetop, AZ

License number
Alaska MEDS3673
Issued Date
Jun 27, 1996
Effective Date
Nov 2, 2006
Expiration Date
Dec 31, 2008
Category
Medical
Address
Address
PO Box 4070, Pinetop, AZ 85935
LicenseFiles verified this license of Nov 18, 2016 at the Alaska - Department of Commerce, Community, and Economic Development.

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