Alysa M. Fog
Physician Assistant
Indiana 10000973A Expired
This Indiana license was held by Alysa M. Fog. The license is no longer active. It was granted on 01/25/2008 and expired on 06/30/2012
LICENSE DETAILS
- License Number: 10000973A
- Category: Physician Assistant
- Status: Expired
- Date Granted: 01/25/2008 (over 18 years ago)
- Expiry Date: 06/30/2012 (almost 14 years ago)
LOCATIONS
A Address
Fort Wayne IN 46825