TIMOTHY JOHN CRISCUOLO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006618

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

JOHN

Last Name

CRISCUOLO

Business Name

TIMOTHY JOHN CRISCUOLO

Original Issue Date

07/09/2018

Effective Date

07/09/2018

Expiration Date

03/01/2020

City

POULSBO

State

Zip

98370

Ever Disciplined

LastModifiedDate

11/24/2020