| Name | KELLY JO FASSETT |
| City/State |
| License and Registration Information | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Credential | License Type | Original Issue | Issue Date | Expiration Date | Status | Discipline | How issued | Description | |||||||
| MA-C.00255- | Medication Aide Certified | 09/11/2012 | 02/24/2014 | 04/30/2016 | ACTIVE | ||||||||||