Massachusetts
Division of Professional Licensure
Tim S Provias
Board Of Registration In Medicine
License number
254220
Date granted
04/10/2013
Date expires
01/08/2018
Class
Board Of Registration In Medicine
Status
Active
Address
Northwestern Medicine, 675 N St Clair St, Galter 19-100
licensingma.org
ID 41468505
LAST UPDATED 2024-04-06 06:44:28 UTC
LAST UPDATED 2024-04-06 06:44:28 UTC
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