ERICA MICHELLE FOVENESI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005290

License Status

NOT RENEWED

Business

First Name

ERICA

Middle

MICHELLE

Last Name

FOVENESI

Business Name

ERICA MICHELLE FOVENESI

Original Issue Date

10/06/2014

Effective Date

10/06/2014

Expiration Date

03/01/2016

City

ROCHESTER HILLS

State

Zip

48306

County

MICHIGAN

Ever Disciplined

LastModifiedDate

04/25/2016