Information as of 09/30/2020

Last Updated by Licensee on 03/10/2020

Michael Tyrone Lewis PA-C
License#: 
Issue Date: 
103247
12/11/2001
License Status: 
Renewal Date:
Active  
04/04/2021  
 Public Action: No
  
Licensee General Information
Active License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
 103247PA-C12/11/2001 
Inactive License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
 103247 12/11/200112/11/2001
Active Supervisor
SupervisorTypeStatusApproval Date
Fajardo, Agapito Lacson MDActive11/30/2004
Hargett, Franklin MDActive12/17/2009
Kelley, Steven Dale MDActive03/17/2010
Yaeger, Edwin Paul DOActive04/20/2012
North Carolina Hospital Admitting Privileges
Sampson Regional Medical Center
Out of State Active/Inactive Licenses
None Reported
Out of Country Active/Inactive Licenses
None Reported