License Verification

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JESUS DIAZ

License Number: ME116567

Data As Of 6/24/2024

Profession
Medical Doctor
License
ME116567
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
06/18/2013
Address of Record
5114 Bird Nest Trail
TALLAHASSEE, FL 32312
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

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Name Relationship Profession License Effective Date
DIAZ, EMILY CLAIRE Subordinate Anesthesiologist Assistants 235 10/13/2014
HAMDEH, SAMIR H Subordinate Anesthesiologist Assistants 218 10/15/2014
LOZANO, FABER DAVID Subordinate Anesthesiologist Assistants 173 10/14/2013
PULFER, MICHAEL RYAN Subordinate Anesthesiologist Assistants 150 12/31/2012
PURSER, BRIAN GARY Subordinate Anesthesiologist Assistants 31 2/9/2015
TAVALAICCIO, ASHLEY LYNN Subordinate Anesthesiologist Assistants 171 10/14/2013
VAN PUTTEN, CAROL PHYLLIS Subordinate Anesthesiologist Assistants 253 3/11/2015

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Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner



No Continuing Education Hours Received from Approved Providers As Of 6/24/2024



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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.


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


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