STACEY LYNN PRATT Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085009706

License Status

ACTIVE

Business

First Name

STACEY

Middle

LYNN

Last Name

PRATT

Business Name

STACEY LYNN PRATT

Original Issue Date

06/12/2023

Effective Date

01/30/2026

Expiration Date

03/01/2028

City

NEW YORK

State

Zip

10019

Ever Disciplined

LastModifiedDate

01/30/2026