License holder summary

TIERRA D PARK is a Medical Physician Assistant licensed to practice in Pennsylvania. The address on file for TIERRA D PARK is Wyomissing PA 19610. This licensed professional license is current. The license was granted 07/18/2011 and expired on 12/31/2016.

Pennsylvania

Department of State

TIERRA D PARK
Medical Physician Assistant
License number
MA055019
Date granted
07/18/2011
Date expires
12/31/2016
Class
Medical Physician Assistant
Status
Active
Address
Wyomissing PA 19610
palicensing.org
ID 16639873
LAST UPDATED 2024-03-31 10:04:36 UTC

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