The holder whose full name is Fodstad, Wendy Marie,come from Indianapolis IN,hold the Physician Assistant - Prescriptive Authority license(NO.10001301A) which status is Active.
| Name | Fodstad, Wendy Marie |
|---|---|
| License Number | 10001301A |
| License Type | Physician Assistant - Prescriptive Authority |
| License Status | Active |
| City | Indianapolis |
| State | IN |