License Verification

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TIMOTHY DALE FOWLER, JR

License Number: PA9110560

Data As Of 5/19/2024

Profession
Physician Assistant
License
PA9110560
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
08/18/2017
Address of Record
4413 US HWY 44
DEFUNIAK SPRINGS, FL 32433
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
615 N Bonito Avenue
PANAMA CITY, FL 32401
Address
449 W 23rd Street
PANAMA CITY, FL 32405
Address
4413 US HWY 31 S
DEFUNIAK SPRINGS, FL 32435
Address
615 N. BONITA BAY MEDICAL SACRED HEART
PANAMA CITY, FL 32401
Address
2600 Hospital Drive
BONIFAY, FL 32425
Name Relationship Profession License Effective Date
ALSHAZLEY, MOUDAR Supervising Prescribing Practitioner Medical Doctor 78728 11/15/2017
ARBUCKLE, SEAN SR Supervising Prescribing Practitioner Osteopathic Physician 11132 09/16/2019
CARLSON, WILLIAM SHAW Supervising Prescribing Practitioner Medical Doctor 121446 02/07/2018
COOK, DARREN LEE Supervising Prescribing Practitioner Osteopathic Physician 5856 01/25/2018
GAILMARD, WILLIAM ROBERT Supervising Prescribing Practitioner Medical Doctor 138184 09/16/2019
KALAJI, ZAHER Supervising Prescribing Practitioner Medical Doctor 73792 11/15/2017
LATHAM, JOSHUA LUKE DO Supervising Prescribing Practitioner Osteopathic Physician 10027 02/07/2018
NODINE, STEVEN LEE Supervising Prescribing Practitioner Osteopathic Physician 11996 03/29/2019
NOGGLE, TOMMY STEVEN MD Supervising Prescribing Practitioner Medical Doctor 93880 11/09/2017
ORBEZO, ANED M Supervising Prescribing Practitioner Medical Doctor 95479 01/28/2019
PHELPS, ANID ORBEZO Supervising Prescribing Practitioner Medical Doctor 94653 01/28/2019
SCOTT, JACK DOUGLAS MD Supervising Prescribing Practitioner Medical Doctor 69637 09/06/2017
SINGLEY, CHRISTOPHER LEE Supervising Prescribing Practitioner Medical Doctor 101636 11/15/2017
THOMPSON, TOMMY GLEN II Supervising Prescribing Practitioner Medical Doctor 128635 11/15/2017

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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 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.