License Verification

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MELISSA CASILLAS BAILEY

License Number: PA9107076

Data As Of 5/19/2024

Profession
Physician Assistant
License
PA9107076
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
01/17/2013
Address of Record
6300 N Wickham Rd Suite 101
MELBOURNE, FL 32940
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
CONNOR, TIMOTHY JAMES Supervising Prescribing Practitioner Medical Doctor 115761 10/01/2018
DEGROAT, JONATHAN THOMAS Supervising Prescribing Practitioner Medical Doctor 114356 03/11/2016
DESAI, AJAY Supervising Prescribing Practitioner Osteopathic Physician 12568 03/17/2016
FORMAN, MITCHELL TODD MD Supervising Prescribing Practitioner Medical Doctor 75537 10/09/2018
KOONKITTI, PARICHART CANDY Supervising Prescribing Practitioner Medical Doctor 125284 03/17/2016
NESSELROADE, RYAN DAVID Supervising Prescribing Practitioner Medical Doctor 106189 03/17/2016
OSBORNE, AARON RYAN Supervising Prescribing Practitioner Medical Doctor 108215 03/11/2016
PALTOO, CATHERINE URMELA Supervising Prescribing Practitioner Medical Doctor 96193 10/09/2018
SECREST, JULIE K Supervising Prescribing Practitioner Medical Doctor 110718 03/17/2016
WETHERINGTON, JENNIFER LYN Supervising Prescribing Practitioner Medical Doctor 97271 10/01/2018

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Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 5/19/2024



* To find out more about Approved Providers, or ask a provider why the course you took is not yet listed, please visit our Continuing Education Providers page.


** Personal Development is limited to no more than 3 hours per renewal cycle. Any personal development hours in excess of this 3 hour maximum cannot be used for renewal and have been subtracted from the total available for renewal.


Please do not fax proof of Continuing Education hours to the Board Office until you have received your renewal notice in the mail.


For instructions on how to request a license certification of your Florida license to be sent to another state from the Florida Department of Health, please visit the License Certifications web page.