Department of State
Board of Medicine
JOSE JAVIER PROVENCIO
Medical Physician And Surgeon
License number
MD071417L
Date granted
06/19/2000
Date expires
12/31/2016
Class
Medical Physician And Surgeon
Status
Active
Address
Cleveland OH 44195
medicinepa.com
ID 37659585
LAST UPDATED 2024-02-12 17:28:25 UTC
LAST UPDATED 2024-02-12 17:28:25 UTC
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