BACON, JENISE VICTORIA
Medical - Physician Assistant
Georgia 004331 Lapsed
This Georgia license was held by BACON, JENISE VICTORIA. The license is no longer active. It was granted on 09/03/2004 and expired on 12/31/2008
LICENSE DETAILS
- License Number: 004331
- Category: Physician Assistant
- Status: Lapsed
- Date Granted: 09/03/2004 (over 20 years ago)
- Expiry Date: 12/31/2008 (over 16 years ago)
LOCATIONS
A Address
2020 KILDARE WOODS DRIVE, Greensboro 27407