License holder summary

Evan P Provisor is a Board Of Registration In Medicine licensed to practice in Massachusetts. The address on file for Evan P Provisor is 100 South Street, Southbridge 01550. This licensed professional license is current. The license was granted 07/23/2008 and expired on 08/24/2017.

Massachusetts

Division of Professional Licensure

Evan P Provisor
Board Of Registration In Medicine
License number
237945
Date granted
07/23/2008
Date expires
08/24/2017
Class
Board Of Registration In Medicine
Status
Active
Address
100 South Street
licensingma.org
ID 41468506
LAST UPDATED 2024-02-25 15:33:01 UTC

This website is unaffiliated with the Division of Professional Licensure. Please verify all information directly with the relevant official government authority.

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