License Verification

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BRIAN M. RIVARD

License Number: PA9111639

Data As Of 11/21/2024

Profession
Physician Assistant
License
PA9111639
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/20/2018
Address of Record
3599 University Blvd S
Bldg 300
JACKSONVILLE, FL 32216
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1350 13th Avenue South
JACKSONVILLE, FL 32250
Address
3599 University Blvd., S
JACKSONVILLE, FL 32216
Address
1900 Tebeau Street
WAYCROSS, GA 31501
Address
2001 Kingsley Avenue
ORANGE PARK, FL 32073
Address
800 Prudential Drive
JACKSONVILLE, FL 32207
Address
14550 St. Augustine Road
JACKSONVILLE, FL 32258
Address
3625 University Blvd., S
JACKSONVILLE, FL 32216
Address
3625 University Blvd., S
JACKSONVILLE, FL 32216
Name Relationship Profession License Effective Date
ALSAHLI, HAITHAM Supervising Prescribing Practitioner Medical Doctor 140232 08/28/2019
BEARDSLEY, SHANNON LEE Supervising Prescribing Practitioner Medical Doctor 70257 07/18/2022
CUNNINGHAM, JAMES CHRISTOPHER Supervising Prescribing Practitioner Osteopathic Physician 10705 08/28/2019
JOHN, CHRISTOPHER M Supervising Prescribing Practitioner Osteopathic Physician 15940 08/28/2019
JOHNSON, CHARLES EDWARD Supervising Prescribing Practitioner Medical Doctor 110710 10/28/2022
KENT, AMANDA SUE Supervising Prescribing Practitioner Osteopathic Physician 13930 02/06/2019
ROURA, DANIEL Supervising Prescribing Practitioner Medical Doctor 133446 02/06/2019
TERHAAR, KENNETH Supervising Prescribing Practitioner Medical Doctor 134708 03/18/2019

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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 11/21/2024



* 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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