License Verification

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KELLY MARIE MULLIKIN

License Number: PA9109308

Data As Of 4/26/2025

Profession
Physician Assistant
License
PA9109308
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
01/06/2016
Address of Record
2931 Alt 19
PALM HARBOR, FL 34683
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
GALLARDO, LUPITA CATRINA Supervising Prescribing Practitioner Medical Doctor 157471 10/17/2022
HUBENAK, JUSTIN RAY Supervising Prescribing Practitioner Medical Doctor 142450 06/01/2022
IRVIN, MATTHEW RUSSELL MD Supervising Prescribing Practitioner Medical Doctor 116354 02/14/2022
LAFLEUR, MELISSA ROSE Supervising Prescribing Practitioner Medical Doctor 142757 05/24/2022
PERRUCI, VALERIA ROSA Supervising Prescribing Practitioner Medical Doctor 99793 06/01/2022
SOUDIJN, PETER NORMAN MD Supervising Prescribing Practitioner Medical Doctor 63325 05/24/2022
ULLO, THOMAS JUDE Supervising Prescribing Practitioner Medical Doctor 97275 06/01/2022

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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 4/26/2025



* 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.