License holder summary

PROVENCIO LISA MARIE is a Pharmacy Technician licensed to practice in California. The address on file for PROVENCIO LISA MARIE is 2404 C STREET #102 SAN DIEGO CA 92102. This pharmacist license is current. The license was granted 11/08/1993 and expired on 01/31/2017.

Department of Consumer Affairs

Board of Pharmacy

PROVENCIO LISA MARIE
Pharmacy Technician
License number
10497
Date granted
11/08/1993
Date expires
01/31/2017
Class
Pharmacy Technician
Status
Clear
Address
2404 C STREET #102 SAN DIEGO CA 92102
californiapharmacists.org
ID 11968877
LAST UPDATED 2026-03-11 04:25:05 UTC

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