Carrie Sue Fortman
Medical - Physician Assistant
Minnesota 9118 Canceled
This Minnesota license was held by Carrie Sue Fortman. The license is no longer active. It was granted on 09/17/1994 and expired on 06/30/1999
LICENSE DETAILS
- License Number: 9118
- Category: Physician Assistant
- Status: Canceled
- Date Granted: 09/17/1994 (over 30 years ago)
- Expiry Date: 06/30/1999 (almost 26 years ago)
LOCATIONS
A Address
3955 - 119th Ave NW, #301, Coon Rapids, MN 55433