CAROL SUE FUENTES Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000863

License Status

NOT RENEWED

Business

First Name

CAROL SUE

Last Name

FUENTES

Business Name

CAROL SUE FUENTES

Original Issue Date

01/09/1997

Effective Date

01/09/1997

Expiration Date

03/01/2002

City

VAFB

State

Zip

93437

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

10/09/2006