The holder whose full name is Fog, Alysa M.,come from Iowa City IA,hold the Physician Assistant - Prescriptive Authority license(NO.10000973A) which status is Probation.
| Name | Fog, Alysa M. |
|---|---|
| License Number | 10000973A |
| License Type | Physician Assistant - Prescriptive Authority |
| License Status | Probation |
| City | Iowa City |
| State | IA |