License holder summary

ELLEN MICHELLE PROVOST is a Medical - Licensed Osteopathic Physician licensed to practice in Alaska. The address on file for ELLEN MICHELLE PROVOST is 3056 GLACIER STREET ANCHORAGE AK 99508. This licensed professional license is current. The license was granted 09/10/1991 and expired on 12/31/2014.

Alaska

Division of Corporations, Business and Professional Licensing

ELLEN MICHELLE PROVOST
Medical - Licensed Osteopathic Physician
License number
2717
Date granted
09/10/1991
Date expires
12/31/2014
Class
Medical - Licensed Osteopathic Physician
Status
Licensed
Address
3056 GLACIER STREET ANCHORAGE AK 99508
alaskalicensing.com
ID 20392049
LAST UPDATED 2024-04-28 05:40:59 UTC

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