License Verification

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JESSICA AMBROSE

License Number: PA9110160

Data As Of 5/19/2024

Profession
Physician Assistant
License
PA9110160
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
01/17/2017
Address of Record
North Okaloosa Medical Center
151 E. Redstone Ave
CRESTVIEW, FL 32539
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
ALLMAN, JEFFREY WILLIAM Supervising Prescribing Practitioner Osteopathic Physician 9007 07/19/2023
ALSHAZLEY, MOUDAR Supervising Prescribing Practitioner Medical Doctor 78728 02/21/2017
ARBUCKLE, SEAN SR Supervising Prescribing Practitioner Osteopathic Physician 11132 07/17/2019
BERRY, SHANNON GAYLE Supervising Prescribing Practitioner Medical Doctor 152055 06/17/2021
CARLSON, WILLIAM SHAW Supervising Prescribing Practitioner Medical Doctor 121446 02/21/2017
COOK, DARREN LEE Supervising Prescribing Practitioner Osteopathic Physician 5856 09/13/2017
CRINER, ROGER D JR Supervising Prescribing Practitioner Medical Doctor 114331 06/21/2021
CUPO, WILLIAM WALTER MD Supervising Prescribing Practitioner Medical Doctor 86389 09/14/2022
DUERR, KARL MICHAEL Supervising Prescribing Practitioner Medical Doctor 151983 05/30/2021
EDLER, RAYME MICHELLE Supervising Prescribing Practitioner Medical Doctor 109913 09/09/2021
GAILMARD, WILLIAM ROBERT Supervising Prescribing Practitioner Medical Doctor 138184 07/17/2019
GEORGE, MATTHEW Supervising Prescribing Practitioner Medical Doctor 164808 10/12/2023
HAMPTON, ZACHARY EDWARD Supervising Prescribing Practitioner Osteopathic Physician 18067 07/13/2023
HARVEY, KYLE Supervising Prescribing Practitioner Medical Doctor 158195 07/19/2023
HWANG, CHARLES WILLIAM JR Supervising Prescribing Practitioner Medical Doctor 126436 07/19/2023
KALAJI, ZAHER Supervising Prescribing Practitioner Medical Doctor 73792 02/21/2017
KOERTNER, ADAM Supervising Prescribing Practitioner Medical Doctor 157233 08/16/2023
KYLE, JAMES MORGAN Supervising Prescribing Practitioner Medical Doctor 83612 07/13/2022
LATHAM, JOSHUA LUKE DO Supervising Prescribing Practitioner Osteopathic Physician 10027 03/08/2018
LITTMAN, NICHOLAS Supervising Prescribing Practitioner Medical Doctor 151791 10/11/2022
MCNEIL, MEGAN IONE Supervising Prescribing Practitioner Medical Doctor 129689 05/02/2021
MEIS, DANIEL ROBERT Supervising Prescribing Practitioner Osteopathic Physician 19686 07/19/2023
MELANCON, ERIC EUGENE Supervising Prescribing Practitioner Medical Doctor 150172 04/12/2021
MULLIS, BARON THAXTON Supervising Prescribing Practitioner Medical Doctor 113789 07/02/2021
NODINE, STEVEN LEE Supervising Prescribing Practitioner Osteopathic Physician 11996 02/21/2017
NOGGLE, TOMMY STEVEN MD Supervising Prescribing Practitioner Medical Doctor 93880 02/21/2017
NUCHERENO, ANTHONY RICHARD Supervising Prescribing Practitioner Osteopathic Physician 17869 07/26/2023
ORBEZO, ANED M Supervising Prescribing Practitioner Medical Doctor 95479 02/21/2017
PATEL, JAIMIN BALWANT M D Supervising Prescribing Practitioner Medical Doctor 104797 02/21/2017
PHELPS, ANID ORBEZO Supervising Prescribing Practitioner Medical Doctor 94653 02/21/2017
PORTER, JAYCE Supervising Prescribing Practitioner Osteopathic Physician 16341 12/23/2019
RASIWALA, AZIMA Supervising Prescribing Practitioner Osteopathic Physician 18254 01/03/2022
RIZZUTO, WILLIAM THOMAS Supervising Prescribing Practitioner Medical Doctor 161389 07/19/2023
RUTH, ROBERT ALLAN Supervising Prescribing Practitioner Medical Doctor 74008 07/25/2023
SHEA, JILL MARIE Supervising Prescribing Practitioner Medical Doctor 136840 07/21/2023
SINGLEY, CHRISTOPHER LEE Supervising Prescribing Practitioner Medical Doctor 101636 02/21/2017
THOMPSON, TOMMY GLEN II Supervising Prescribing Practitioner Medical Doctor 128635 07/25/2017
WALKER, ROBERT KENNETH Supervising Prescribing Practitioner Medical Doctor 163903 07/26/2023
WEST, KERRI ELESE Supervising Prescribing Practitioner Osteopathic Physician 18404 10/20/2021
WESTBROOK, JAMES WESLEY Supervising Prescribing Practitioner Medical Doctor 146630 08/18/2023

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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.