License holder summary

SUSAN MARIE FONTAINE is a Physician's Assistant - Physician Assistant licensed to practice in Michigan. The address on file for SUSAN MARIE FONTAINE is Warren, MI 48092. This licensed professional license is current. The license was granted 09/27/2004 and expired on 08/31/2015.

Michigan

Department of Licensing and Regulation

SUSAN MARIE FONTAINE
Physician's Assistant - Physician Assistant
License number
5601004304
Date granted
09/27/2004
Date expires
08/31/2015
Class
Physician's Assistant - Physician Assistant
Status
Active
Address
Warren, MI 48092
michiganlicensing.org
ID 25992125
LAST UPDATED 2024-04-21 09:45:39 UTC

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