License holder summary

SUSAN A FORTNAM is a Medical Physician Assistant licensed to practice in Pennsylvania. The address on file for SUSAN A FORTNAM is GIBSONIA PA 15044. This licensed professional license is current. The license was granted 12/28/1979 and expired on 12/31/2016.

Pennsylvania

Department of State

SUSAN A FORTNAM
Medical Physician Assistant
License number
MA000055L
Date granted
12/28/1979
Date expires
12/31/2016
Class
Medical Physician Assistant
Status
Active
Address
GIBSONIA PA 15044
palicensing.org
ID 37694280
LAST UPDATED 2024-03-13 01:19:46 UTC

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