Ginger Marie Provo
ExpiredCalifornia license 630145
License
- Licensed by
- California Board of Registered Nursing
- License number
- 630145
- Status
- Expired (Delinquent)
- First issued
- December 12, 2003
- Expired
- June 30, 2005
- License holder
- Ginger Marie Provo
- Entity type
- Individual
Classifications
- Registered Nurse Nursing
More from the license record
- License type code
- 4001
Contact
7817 Moose Run Cr
Anchorage, AK 99507
Anchorage, AK 99507
Anchorage County