License Verification

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SAMANTHA LEE JUSINO

License Number: PA9110617

Data As Of 9/28/2024

Profession
Physician Assistant
License
PA9110617
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
09/01/2017
Address of Record
4235 Kings highway
Suite 103
Pulmonary, Sleep & Crit. Care Specialist
PUNTA GORDA, FL 33980
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
21298 OLEAN BLVD FAWCETT MEMORIAL HOSPITAL
PORT CHARLOTTE, FL 33952
Address
4235 Kings Highway Suite 103 Pulmonary, Sleep & Crit. Care Specialist
PORT CHARLOTTE, FL 33980
Address
14942 Tamiami Trial Unit A & B pulmonary, Sleep & Critical Care Spec
NORTH PORT, FL 34287
Address
25086 Olympia Avenue Unit 300 Pulmonary, Sleep & Crit. Care Specialist
PUNTA GORDA, FL 33950
Name Relationship Profession License Effective Date
GERBER, JOEL LAWRENCE Supervising Dispensing Practitioner Medical Doctor 84098 08/31/2020
HOLLAND, REUBEN WRIGHT III Supervising Dispensing Practitioner Medical Doctor 55507 08/31/2020

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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 9/28/2024



* 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.


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