License holder summary

LISA M PROVO is a Nurse - Registered Nurse licensed to practice in Utah. The address on file for LISA M PROVO is BERNHARDS BAY, NY 13028. This nurse license is not current. The license was granted 03/18/1983 and expired on 12/31/1989.

Division of Occupational and Professional Licensing

Board of Nursing

LISA M PROVO
Nurse - Registered Nurse
License number
211632-3105
Date granted
03/18/1983
Date expires
12/31/1989
Class
Nurse - Registered Nurse
Status
Expired
Address
BERNHARDS BAY, NY 13028
nursingutah.org
ID 29848253
LAST UPDATED 2026-05-25 09:23:14 UTC

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