Information as of 07/08/2020

Last Updated by Licensee on 05/13/2020

Fawne Melissa Woosley PA-C
License#: 
Issue Date: 
0010-09130
06/05/2019
License Status: 
Renewal Date:
Active  
06/15/2021  
 Public Action: No
  
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
South Carolina
Out of Country Active/Inactive Licenses
None Reported