WAYNE ADDISON PROVOST
Dental - Dentist Anesthesia Class Ii Permit
Utah 132912-9922 Expired
This Utah license was held by WAYNE ADDISON PROVOST. The license is no longer active. It was granted on 01/01/1910 and expired on 05/31/1996
LICENSE DETAILS
- License Number: 132912-9922
- Category: DENTIST - ANESTHESIA CLASS II PERMIT
- Status: Expired
- Date Granted: 01/01/1910 (over 115 years ago)
- Expiry Date: 05/31/1996 (almost 29 years ago)
LOCATIONS
A Address
SALT LAKE CITY, UT 841090151