Information as of 08/18/2019

Last Updated by Licensee on 06/06/2019

Fawne Melissa Woosley PA-C
License#: 
Issue Date: 
0010-09130
06/05/2019
License Status: 
Renewal Date:
Active  
06/15/2020  
 Public Action: Yes
 See: Actions-Adverse & Administrative Tab
Licensee General Information
Active License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
 0010-09130PA-C06/05/2019 
Inactive License
Active Supervisor
SupervisorTypeStatusApproval Date
Baksh, Javid Mu'Az DOActive06/05/2019
Mallard, Christopher Jordan MDActive07/16/2019
North Carolina Hospital Admitting Privileges
Out of State Active/Inactive Licenses
None Reported
Out of Country Active/Inactive Licenses
None Reported