STACY DEL CARMEN MEDINA Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085009740

License Status

ACTIVE

Business

First Name

STACY

Middle

DEL CARMEN

Last Name

MEDINA

Business Name

STACY DEL CARMEN MEDINA

Original Issue Date

06/23/2023

Effective Date

02/07/2024

Expiration Date

03/01/2026

City

HICKSVILLE

State

Zip

11801

Ever Disciplined

LastModifiedDate

12/03/2025