DEANNE JANET FOWLER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004491

License Status

NOT RENEWED

Business

First Name

DEANNE

Middle

JANET

Last Name

FOWLER

Business Name

DEANNE JANET FOWLER

Original Issue Date

10/09/2012

Effective Date

03/02/2022

Expiration Date

03/01/2024

City

CHARLESTON

State

Zip

29414

Ever Disciplined

LastModifiedDate

02/05/2025