License holder summary

Dr. MATTHEW THOMAS PROVENCHER is a Board Of Medicine licensed to practice in Idaho. The address on file for Dr. MATTHEW THOMAS PROVENCHER is 115 SHERBORNE ROAD BARRINGTON NH 03825. This licensed professional license is not current. The license was granted 12/20/2010 and expired on 08/01/2013.

Idaho

Division of Occupational and Professional Licenses

Dr. MATTHEW THOMAS PROVENCHER
Board Of Medicine
License number
M-11180
Date granted
12/20/2010
Date expires
08/01/2013
Class
Board Of Medicine
Status
Canceled
Address
115 SHERBORNE ROAD BARRINGTON NH 03825
idaholicensing.com
ID 48360164
LAST UPDATED 2024-04-29 08:24:04 UTC

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