Idaho
Division of Occupational and Professional Licenses
PATRICIA ANN PROVINE
State Occupational Therapy Licensure Board - Occupational Therapist
License number
OT - 712
Date granted
09/23/2004
Date expires
09/12/2016
Class
State Occupational Therapy Licensure Board - Occupational Therapist
Status
Current
Address
COEUR D ALENE ID 83814
idaholicensing.com
ID 43729044
LAST UPDATED 2024-03-04 17:51:33 UTC
LAST UPDATED 2024-03-04 17:51:33 UTC
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