FREDERICK THOMAS FEDOROWICZ Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007420

License Status

ACTIVE

Business

First Name

FREDERICK

Middle

THOMAS

Last Name

FEDOROWICZ

Business Name

FREDERICK THOMAS FEDOROWICZ

Original Issue Date

10/29/2019

Effective Date

02/02/2026

Expiration Date

03/01/2028

City

LA CROSSE

State

Zip

54601

Ever Disciplined

LastModifiedDate

02/02/2026