License Verification

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BEAU BRIAN NACKE

License Number: PA9110469

Data As Of 11/21/2024

Profession
Physician Assistant
License
PA9110469
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
07/11/2017
Address of Record
1055 Saxon Blvd
ORANGE CITY, FL 32763
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
JACOBSON, MARK DAVID Supervising Prescribing Practitioner Medical Doctor 67158 03/08/2022
LIVINGSTON, ROBERT TERENCE Supervising Prescribing Practitioner Medical Doctor 83159 08/08/2017
MCNAMEE, JUSTIN JAMES Supervising Prescribing Practitioner Osteopathic Physician 12888 08/08/2017
MOSES, DUSTY ALLEN DR Supervising Prescribing Practitioner Medical Doctor 115932 08/08/2017
MUCCIOLO, PAUL MD Supervising Prescribing Practitioner Medical Doctor 69281 08/08/2017
RAMIA, MICHELLE MARIE Supervising Prescribing Practitioner Medical Doctor 116871 08/08/2017
SISKO, MATTHEW DAVID Supervising Prescribing Practitioner Medical Doctor 111919 08/08/2017
WEINER, TRACY I DO Supervising Prescribing Practitioner Osteopathic Physician 7471 08/08/2017

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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 11/22/2024



* 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.