License holder summary

PROVENZANO, ALICIA PATRICIA is a Medical - Physician Assistant licensed to practice in Georgia. The address on file for PROVENZANO, ALICIA PATRICIA is 299 NORTH BROAD ST., Winder 30680. This doctor license is current. The license was granted 11/02/2012 and expired on 09/30/2016.

Georgia

Composite Medical Board

PROVENZANO, ALICIA PATRICIA
Medical - Physician Assistant
License number
006650
Date granted
11/02/2012
Date expires
09/30/2016
Class
Medical - Physician Assistant
Status
Active
Address
299 NORTH BROAD ST.
georgiadoctors.net
ID 38100920
LAST UPDATED 2026-05-21 08:02:08 UTC

This website is unaffiliated with the Composite Medical Board. Please verify all information directly with the relevant official government authority.

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