PROFESSIONAL LICENSING APPEAL – PENNSYLVANIA

CAPTION

Before [Agency/Board/Commonwealth Court if ARL applies]
[LICENSEE NAME], Petitioner,
v.
[AGENCY/BOARD NAME], Respondent.

INTRODUCTION

• Appeal/challenge to [Denial/Discipline/Suspension/Revocation] of [License Type] dated [DATE].

JURISDICTION AND TIMELINESS

• Filed within [30] days under [agency rule/statute] and 2 Pa.C.S. § 702 (Administrative Agency Law) if applicable; exhaustion satisfied.

VENUE

• Commonwealth Court (unless statute specifies another forum) or designated court per enabling statute.

ISSUES PRESENTED

• [Issue 1]
• [Issue 2] (as needed)

STATEMENT OF FACTS

• Chronology of application/discipline, notices, hearings, findings.

ERRORS AND ARGUMENT

• Lack of substantial evidence; arbitrary/capricious; errors of law under [cite].
• Due process concerns if notice/opportunity was deficient.

RELIEF REQUESTED

• Reverse/modify decision; reinstate or grant license; remand if necessary; stay requested [Yes/No].

EXHIBITS

• Determination/order; transcript excerpts; affidavits; key record exhibits.

SERVICE

• Serve agency and Office of Attorney General (or agency counsel) per applicable rules; include proof of service.

SIGNATURE

[Name, Bar No.]
[Address, Email, Phone]
Counsel for [LICENSEE]