License holder summary

LISA ANN FASOLAK is a Temporary Expanded Function Dental Assistant licensed to practice in Pennsylvania. The address on file for LISA ANN FASOLAK is FOUNTAINVILLE PA 18923. This licensed professional license is not current. The license was granted 02/22/1999.

Pennsylvania

Department of State

LISA ANN FASOLAK
Temporary Expanded Function Dental Assistant
License number
DF002009L
Date granted
02/22/1999
Class
Temporary Expanded Function Dental Assistant
Status
Voided
Address
FOUNTAINVILLE PA 18923
palicensing.org
ID 16560245
LAST UPDATED 2024-05-01 23:08:12 UTC

This website is unaffiliated with the Department of State. Please verify all information directly with the relevant official government authority.

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