License holder summary

GLEN KENNETH PROVIDENCE is a Medical Physician And Surgeon licensed to practice in Pennsylvania. The address on file for GLEN KENNETH PROVIDENCE is Hermitage PA 16148. This medical practitioner license is not current. The license was granted 08/05/2011 and expired on 12/31/2014.

Department of State

Board of Medicine

GLEN KENNETH PROVIDENCE
Medical Physician And Surgeon
License number
MD443812
Date granted
08/05/2011
Date expires
12/31/2014
Class
Medical Physician And Surgeon
Status
Expired
Address
Hermitage PA 16148
medicinepa.com
ID 37660897
LAST UPDATED 2026-04-29 18:06:36 UTC

This website is unaffiliated with the Board of Medicine. Please verify all information directly with the relevant official government authority.

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