The holder whose full name is Clemens, Lisa Michelle,come from Fort Wayne IN,hold the Physician Assistant - Prescriptive Authority license(NO.10001224A) which status is Active.
| Name | Clemens, Lisa Michelle |
|---|---|
| License Number | 10001224A |
| License Type | Physician Assistant - Prescriptive Authority |
| License Status | Active |
| City | Fort Wayne |
| State | IN |