License holder summary

Mallory Margaret Johansen is a Medical - Physician Assistant licensed to practice in Colorado. The address on file for Mallory Margaret Johansen is 6084 S Fairfax Ct, Centennial, CO, 80121-3301. This licensed professional license is current. The license was granted 10/10/2014 and expired on 01/31/2016.

Colorado

Division of Professions and Occupations

Mallory Margaret Johansen
Medical - Physician Assistant
License number
4112
Date granted
10/10/2014
Date expires
01/31/2016
Class
Medical - Physician Assistant
Status
Active
Address
6084 S Fairfax Ct, Centennial, CO, 80121-3301
coloradolicensing.org
ID 28291069
LAST UPDATED 2026-05-28 14:45:34 UTC

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