| Physician Search | ||
| Physician Records |
| Physician Last Name: | Fague | |||
| Physician First Name: | Carol | |||
| Physician Middle Name: | Diane | |||
| Address: | Address Redacted | |||
| License Number: | 013304 | |||
| License Type: | PA | |||
| Year of Birth: | 1982 | |||
| Effective Date: | 01/11/2021 | |||
| Action Description for DOH Webpage: | License Surrender | |||
| Misconduct Description for DOH Webpage: | The physician assistant did not contest the charge of committing professional misconduct by practicing the profession with negligence on more than one occasion. | |||
| License Limitations or Conditions for DOH Webpage: | ||||
| Board Order: |
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