License holder summary

Stephen Christopher Provenza is a Controlled Substance Registration-Physician Assistant licensed to practice in Indiana. The address on file for Stephen Christopher Provenza is Foundations Family Medicine, 905 W Keegan's Way, Greensburg IN 47240. This licensed professional license is not current. The license was granted 03/27/2009 and expired on 06/30/2010.

Indiana

Professional Licensing Agency

Stephen Christopher Provenza
Controlled Substance Registration-Physician Assistant
License number
10001076B
Date granted
03/27/2009
Date expires
06/30/2010
Class
Controlled Substance Registration-Physician Assistant
Status
Expired
Address
Foundations Family Medicine, 905 W Keegan's Way, Greensburg IN 47240
indianalicensing.org
ID 8386823
LAST UPDATED 2024-02-15 04:29:27 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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