Ohio
Board of Licensing
Glen Kenneth Providence
Medical Board - 57.Md Training Certificate
License number
57.014514
Date granted
07/11/2008
Date expires
06/30/2011
Class
Medical Board - 57.Md Training Certificate
Status
Inactive
Address
St Elizabeth Health Center, c/o Medical Education Dept, 1044 Belmont Avenue, Youngstown, OH 44501
ohiolicensing.org
ID 28994195
LAST UPDATED 2024-04-21 17:05:08 UTC
LAST UPDATED 2024-04-21 17:05:08 UTC