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Jackeline
Jackeline
Fagan
Clinical laboratory personnel
Pembroke Pines, United States
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Florida Health Care Practitioner Data Portal
Full name
JACKELINE FAGAN
Job Title
Clinical Laboratory Personnel
Location
Pembroke Pines, FL, USA
LIC ID
39300
Current License Expiration Date
31/08/2024
Original Date
19/07/2006
Professional Rank Code
SU
Effective Date
19/07/2006
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
BROWARD
Practice Location Address Line 1
10200 COMMERCE PARKWAY
Practice Location Address City
MIRAMAR
Practice Location Address State
FL
Practice Location Address Zipcode
33025
Mode Code
Microbiology Supervisor
Prescribing Indicator
N
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