EBBIE J PROVENZANO
Nursing at Ross Clark Cir, Dothan, AL

License number
Florida 3058932
Issued Date
Jun 13, 1996
Effective Date
May 15, 2012
Expiration Date
Apr 30, 2010
Category
Health Care
Type
Registered Nurse
Address
Address 2
2932 Ross Clark Cir, Dothan, AL 36301
1119 Crk 92, Graball, AL 36310