License holder summary

JUSTIN SHAYNE FANNING is a Graduate Medical Trainee licensed to practice in Pennsylvania. The address on file for JUSTIN SHAYNE FANNING is Grand Rapids MI 49546. This medical practitioner license is not current. The license was granted 07/09/2002 and expired on 06/30/2004.

Department of State

Board of Medicine

JUSTIN SHAYNE FANNING
Graduate Medical Trainee
License number
MT180914
Date granted
07/09/2002
Date expires
06/30/2004
Class
Graduate Medical Trainee
Status
Inactive
Address
Grand Rapids MI 49546
medicinepa.com
ID 37531299
LAST UPDATED 2024-05-03 03:41:17 UTC

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