License Verification

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JENNIFER GULDAGER

License Number: PA9110691

Data As Of 11/22/2024

Profession
Physician Assistant
License
PA9110691
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/19/2017
Address of Record
11951 US HWY 1 Ste. #118
NORTH PALM BEACH, FL 33408
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
3537 Forest Hill Blvd
WEST PALM BEACH, FL 33406
Address
5818 South Dixie highway
WEST PALM BEACH, FL 33405
Name Relationship Profession License Effective Date
BRUNDRETT, LISA KAY Supervising Prescribing Practitioner Osteopathic Physician 8290 03/12/2024
SALEHI, SHARIF O MD Supervising Prescribing Practitioner Medical Doctor 72659 09/26/2022

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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 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.


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