License holder summary

THERESA A MICKNICK is a Medical Physician Assistant licensed to practice in Pennsylvania. The address on file for THERESA A MICKNICK is Jermyn PA 18433. This licensed professional license is current. The license was granted 03/12/1993 and expired on 12/31/2016.

Pennsylvania

Department of State

THERESA A MICKNICK
Medical Physician Assistant
License number
MA001651L
Date granted
03/12/1993
Date expires
12/31/2016
Class
Medical Physician Assistant
Status
Active
Address
Jermyn PA 18433
palicensing.org
ID 16633677
LAST UPDATED 2024-04-08 03:53:44 UTC

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