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Licenses
Dentist
Utah
1360468903
Larry Jay Broadbent
Dentist in Provo, UT
License number
Utah 136046-8903
Issued Date
Sep 12, 1988
Expiration Date
May 31, 2006
Category
Dental
Type
Dentist Controlled Substance (Schedule 2-5)
Address
Address
Provo, UT
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