Arizona
Board of Licensing
Theresa Doherty Koppal PA
Physician Assistant
License number
5748
Date granted
09/02/2014
Class
Physician Assistant
Status
Active
Address
Main Street Family Practice, 660 S. Main Street, Florence AZ 85132
arizonalicensing.com
ID 22779022
LAST UPDATED 2024-03-22 21:37:47 UTC
LAST UPDATED 2024-03-22 21:37:47 UTC