License holder summary

BACON, JENISE VICTORIA is a Medical - Physician Assistant licensed to practice in Georgia. The address on file for BACON, JENISE VICTORIA is 2020 KILDARE WOODS DRIVE, Greensboro 27407. This doctor license is not current. The license was granted 09/03/2004 and expired on 12/31/2008.

Georgia

Composite Medical Board

BACON, JENISE VICTORIA
Medical - Physician Assistant
License number
004331
Date granted
09/03/2004
Date expires
12/31/2008
Class
Medical - Physician Assistant
Status
Lapsed
Address
2020 KILDARE WOODS DRIVE
georgiadoctors.net
ID 38096370
LAST UPDATED 2024-04-02 00:06:07 UTC

This website is unaffiliated with the Composite Medical Board. Please verify all information directly with the relevant official government authority.

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