License Verification

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ROGER D CRINER JR

License Number: ME114331

Data As Of 11/21/2024

Profession
Medical Doctor
License
ME114331
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
10/05/2012
Address of Record
10207 SHREWSBURY RUN WEST
COLLIERVILLE, TN 38017
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
WEST, KERRI ELESE Supervising Prescribing Practitioner Osteopathic Physician 18404 10/20/2021

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Name Relationship Profession License Effective Date
AMBROSE, JESSICA Prescribing Physician Assistant Physician Assistant 9110160 6/21/2021
BERRY, RANAE SHANNON Prescribing Physician Assistant Physician Assistant 9103545 6/21/2021
BULLMAN, JONATHAN FAIN Prescribing Physician Assistant Physician Assistant 9107709 6/21/2021
EVERETT, WARREN UMANDAP Prescribing Physician Assistant Physician Assistant 9105831 6/21/2021
PATRONIS ADAMS, MARIA Prescribing Physician Assistant Physician Assistant 9111206 6/21/2021
SAMSON, JESSICA AURELIO Prescribing Physician Assistant Physician Assistant 9103076 6/2/2021
SIMMONS, LEONARD WILLIAM Prescribing Physician Assistant Physician Assistant 9103209 6/21/2021
WILEY, AMY HELEN Prescribing Physician Assistant Physician Assistant 9111747 6/21/2021
WINDFELDER, CHARLES BERNARD Prescribing Physician Assistant Physician Assistant 9103273 6/21/2021

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 11/21/2024



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** 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.


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