MICHELLE AYA FUKUDA Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085011874

License Status

ACTIVE

Business

First Name

MICHELLE

Middle

AYA

Last Name

FUKUDA

Business Name

MICHELLE AYA FUKUDA

Original Issue Date

11/06/2025

Effective Date

01/15/2026

Expiration Date

03/01/2028

City

MAPLEWOOD

State

Zip

07040

Ever Disciplined

LastModifiedDate

03/03/2026