Tatjana S Provost
ExpiredCalifornia license 601958
License
- Licensed by
- California Board of Registered Nursing
- License number
- 601958
- Status
- Expired (Delinquent)
- First issued
- July 15, 2002
- Expired
- November 30, 2013
- License holder
- Tatjana S Provost
- Entity type
- Individual
Classifications
- Registered Nurse Nursing
More from the license record
- License type code
- 4001
Contact
168 E Street
Salt Lake City, UT 84103
Salt Lake City, UT 84103
Salt Lake County