Michigan
Department of Licensing and Regulation
MARY ELLEN FAVATA
Nurse Registered & Licensed Practical - Nurse Practitioner
License number
4704126972
Date granted
08/14/2008
Date expires
03/31/2016
Class
Nurse Registered & Licensed Practical - Nurse Practitioner
Status
Active
Address
East China, MI 48054
michiganlicensing.org
ID 25858141
LAST UPDATED 2026-05-11 17:55:54 UTC
LAST UPDATED 2026-05-11 17:55:54 UTC
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