The holder whose full name is PROVENZO, ANGELO MICHAEL,come from COLUMBUS IN,hold the Psychologist license(NO.20010515A) which status is Expired.
| Name | PROVENZO, ANGELO MICHAEL |
|---|---|
| License Number | 20010515A |
| License Type | Psychologist |
| License Status | Expired |
| City | COLUMBUS |
| State | IN |