License Verification

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LYNN RAE THIBODEAU

License Number: PA9107879

Data As Of 4/25/2025

Profession
Physician Assistant
License
PA9107879
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
04/09/2014
Address of Record
4689 US Highway 17
Suites 2-5
Florida Cancer Specialty & Research Inst
FLEMING ISLAND, FL 32003
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
BUBIS, JEFFREY ALAN Supervising Prescribing Practitioner Osteopathic Physician 9446 09/28/2018
FERDMAN, ROBERT Supervising Prescribing Practitioner Medical Doctor 157835 12/12/2022
GEORGE, LIJI MD Supervising Prescribing Practitioner Medical Doctor 106014 05/12/2020
KENT, ELIZABETH COONEY Supervising Prescribing Practitioner Medical Doctor 116639 09/28/2018
VILLEGAS, AUGUSTO ENRIQUE Supervising Prescribing Practitioner Medical Doctor 88469 09/28/2018

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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 4/25/2025



* 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.