License Verification

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KELLY ANN GRAHAM

License Number: PA9112573

Data As Of 5/19/2024

Profession
Physician Assistant
License
PA9112573
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/20/2019
Address of Record

This practitioner does not have an address of record on file with the department. If you have any questions, please contact the department at (850) 488-0595.

Address of Record
NOT PRACTICING
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
ACOSTA TAPIA, HECTOR JAVIER Supervising Prescribing Practitioner Medical Doctor 95153 10/24/2019
BABB, KEVIN OLIVER Supervising Prescribing Practitioner Medical Doctor 130725 10/23/2019
BACASNOT, JEROME Supervising Prescribing Practitioner Medical Doctor 132578 10/24/2019
BARAJAS, FERNANDO Supervising Prescribing Practitioner Medical Doctor 134745 10/24/2019
BASTERRECHEA, HUGO ROMULO Supervising Prescribing Practitioner Medical Doctor 104965 10/23/2019
BAUMGARDNER, MAXEN LANE Supervising Prescribing Practitioner Osteopathic Physician 10872 10/23/2019
BENNETT, MILES CLARK Supervising Prescribing Practitioner Osteopathic Physician 10955 10/23/2019
BIRENBAUM, DALE SCOTT MD Supervising Prescribing Practitioner Medical Doctor 72696 10/23/2019
BISHOP, DAVID Supervising Prescribing Practitioner Osteopathic Physician 14926 10/24/2019
BLEVINS, GRAIG EDWARD Supervising Prescribing Practitioner Osteopathic Physician 12408 10/23/2019
BOSTICK, BARBARA BARRIE Supervising Prescribing Practitioner Medical Doctor 137562 10/24/2019
BOWLS, BRADFORD JORDAN Supervising Prescribing Practitioner Medical Doctor 76194 10/23/2019
BRAHMBHATT, ALKESH PRAVIN Supervising Prescribing Practitioner Osteopathic Physician 8985 10/23/2019
CABATU, AMABEL-JOVAN CHUA MD Supervising Prescribing Practitioner Medical Doctor 96128 10/23/2019
CAMACHO-ACEVEDO, LESLIE ROSIE Supervising Prescribing Practitioner Medical Doctor 125213 10/23/2019
CARON, JESSE ANTHONY Supervising Prescribing Practitioner Medical Doctor 99918 10/24/2019
CHARNAS, JEANNE MARIE SMREKAR Supervising Prescribing Practitioner Medical Doctor 72486 10/23/2019
CHEESEBREW, JOHN FRANKLIN II Supervising Prescribing Practitioner Medical Doctor 119183 10/23/2019
CHESLOCK, TIMOTHY JOHN Supervising Prescribing Practitioner Osteopathic Physician 12099 10/23/2019
CHIN, KEVIN WESLEY Supervising Prescribing Practitioner Medical Doctor 130328 10/23/2019
CISNEROS, LEONARDO Supervising Prescribing Practitioner Osteopathic Physician 8015 10/23/2019
CLAYTON, JEROME Supervising Prescribing Practitioner Medical Doctor 127193 10/23/2019
CLEVELAND, RENEE MICHELLE Supervising Prescribing Practitioner Medical Doctor 79367 10/23/2019
COOPER, HERBERT PRESS III Supervising Prescribing Practitioner Medical Doctor 91330 10/23/2019
DALEY, JANIN CHRISTIN Supervising Prescribing Practitioner Medical Doctor 123412 10/23/2019
DENNEY, CLIFFORD JOSEPH MD Supervising Prescribing Practitioner Medical Doctor 106797 10/23/2019
DIAZ BALZAC, ROBERTO J Supervising Prescribing Practitioner Medical Doctor 127423 10/24/2019
DOTSON, TRACE M Supervising Prescribing Practitioner Osteopathic Physician 12691 10/24/2019
FERNANDEZ FERNANDEZ, JUAN RAFAEL Supervising Prescribing Practitioner Medical Doctor 127278 10/24/2019
FRIEND, VICKI KAY DO Supervising Prescribing Practitioner Osteopathic Physician 7562 10/24/2019
FRISCH, MARK SCOTT Supervising Prescribing Practitioner Medical Doctor 96093 10/23/2019
GALLEGOS, LAURA ELISA ALDARONDO Supervising Prescribing Practitioner Medical Doctor 107281 10/23/2019
GOLDMAN, DAVID DO Supervising Prescribing Practitioner Osteopathic Physician 8129 10/23/2019
GRAZIANO, JENNY D Supervising Prescribing Practitioner Medical Doctor 99574 10/23/2019
GREGORY, CHRISTEN NICHOLE MD Supervising Prescribing Practitioner Medical Doctor 118702 10/24/2019
GUE, SHAYNE MICHAEL Supervising Prescribing Practitioner Medical Doctor 129308 10/24/2019
GUZMAN MARTINEZ, SAMUEL Supervising Prescribing Practitioner Medical Doctor 89143 10/24/2019
HARBOUR, DAVID MARK Supervising Prescribing Practitioner Osteopathic Physician 8124 07/01/2021
HAUS, DOUGLAS MARTIN Supervising Prescribing Practitioner Osteopathic Physician 12432 10/24/2019
HERNANDEZ, DENNIS ARNALDO Supervising Prescribing Practitioner Medical Doctor 55104 10/24/2019
HORNER, KIMBERLY BOGARD Supervising Prescribing Practitioner Medical Doctor 129828 10/24/2019
ISA, IBRAHIM Supervising Prescribing Practitioner Medical Doctor 131853 10/24/2019
JANWADKAR, SHAKUNTALA SANDEEP MD Supervising Prescribing Practitioner Medical Doctor 86339 10/24/2019
JEAN-BAPTISTE, NAOMI Supervising Prescribing Practitioner Medical Doctor 137930 10/24/2019
KOSCINSKI, FELICE ILENE Supervising Prescribing Practitioner Medical Doctor 70986 10/24/2019
KRUGER, MARK SAUL Supervising Prescribing Practitioner Medical Doctor 43984 10/24/2019
LANKER, MARK DARRYL Supervising Prescribing Practitioner Medical Doctor 111494 10/24/2019
LAPP, JOHN KOEHLER Supervising Prescribing Practitioner Osteopathic Physician 4816 10/24/2019
LIN, EDWARD C Supervising Prescribing Practitioner Osteopathic Physician 11547 07/01/2021
MANSFIELD, OMAYRA LIZZIE Supervising Prescribing Practitioner Medical Doctor 111757 10/24/2019
MAULDIN, JUSTIN ANTHONY Supervising Prescribing Practitioner Medical Doctor 131802 10/24/2019
MAULFAIR, MITCHELL DEAN Supervising Prescribing Practitioner Osteopathic Physician 7054 10/24/2019
MCLAIN, JOHN IV Supervising Prescribing Practitioner Medical Doctor 118207 10/24/2019
MILLARD, CHRISTOPHER J DO Supervising Prescribing Practitioner Osteopathic Physician 6911 10/24/2019
MIRANDA GONZALEZ, EDGAR JAVIER Supervising Prescribing Practitioner Medical Doctor 132070 10/24/2019
MOLINS, CAROLINE MARIE Supervising Prescribing Practitioner Medical Doctor 107349 10/24/2019
MORA MONTERO, CLARA JULIANA Supervising Prescribing Practitioner Medical Doctor 122709 10/24/2019
NAZARIO, STEVEN Supervising Prescribing Practitioner Medical Doctor 87429 10/24/2019
NEVALA, WAYNE MICHAEL M D Supervising Prescribing Practitioner Medical Doctor 83654 10/24/2019
NICHOLS, PATRICIA Supervising Prescribing Practitioner Medical Doctor 89338 10/24/2019
NOBIE, BRIAN A Supervising Prescribing Practitioner Medical Doctor 87679 10/24/2019
OAKLEY, ANGELA GARCIA M D Supervising Prescribing Practitioner Medical Doctor 56710 10/23/2019
O'BRIEN, PAUL BLAKE MD Supervising Prescribing Practitioner Medical Doctor 95514 10/24/2019
O'GRADY, LISA M Supervising Prescribing Practitioner Medical Doctor 69380 10/24/2019
PAGE, ERNEST II Supervising Prescribing Practitioner Medical Doctor 78546 10/24/2019
PERRY, PAMELA MARIA MD Supervising Prescribing Practitioner Medical Doctor 108679 10/24/2019
PICKETT, MICHAEL JOSEPH Supervising Prescribing Practitioner Medical Doctor 124561 10/24/2019
POOLE, RICHARD M DO Supervising Prescribing Practitioner Osteopathic Physician 13735 10/24/2019
PUTIGNA, FLORIANO Supervising Prescribing Practitioner Osteopathic Physician 8905 10/24/2019
REYES SANTOS, ALEX FRANCISCO Supervising Prescribing Practitioner Medical Doctor 132290 10/24/2019
RODRIGUEZ, EDGARDO MD Supervising Prescribing Practitioner Medical Doctor 65647 10/24/2019
RODRIGUEZ, MARITZA RODRIGUEZ Supervising Prescribing Practitioner Medical Doctor 69301 10/24/2019
RUTLEDGE, AMANDA CRICHLOW Supervising Prescribing Practitioner Medical Doctor 130563 10/24/2019
SANDERS, BRETT DOUGLAS Supervising Prescribing Practitioner Medical Doctor 115172 10/24/2019
SANTAMBROSIO, MARC Supervising Prescribing Practitioner Osteopathic Physician 8725 10/24/2019
SARKARATI, DAVID Supervising Prescribing Practitioner Osteopathic Physician 9010 10/24/2019
SECREST, JULIE K Supervising Prescribing Practitioner Medical Doctor 110718 10/24/2019
SIMMONDS, YARELIES MALAVE Supervising Prescribing Practitioner Medical Doctor 126238 10/24/2019
SING, WEYLIN Supervising Prescribing Practitioner Osteopathic Physician 8721 10/24/2019
SMOLTER, PATRICIA ELIZABETH Supervising Prescribing Practitioner Osteopathic Physician 12707 10/24/2019
TEMPEL, RICHARD ANDREW MD Supervising Prescribing Practitioner Medical Doctor 102329 10/24/2019
THABET, ASHRAF Supervising Prescribing Practitioner Osteopathic Physician 11277 10/24/2019
THOMETZ, DONALD PAUL Supervising Prescribing Practitioner Medical Doctor 130218 10/24/2019
THOMPSON, HOLLY JEAN Supervising Prescribing Practitioner Medical Doctor 126424 10/24/2019
TOMECSEK, KEVIN JOSEPH Supervising Prescribing Practitioner Medical Doctor 123302 10/24/2019
VANDERVELDE, KRISTEN C Supervising Prescribing Practitioner Osteopathic Physician 12002 10/24/2019
WARTELLA, JOHN DOUGLAS MD Supervising Prescribing Practitioner Medical Doctor 99649 10/23/2019
WEAGRAFF, NATHAN ZACHARY Supervising Prescribing Practitioner Medical Doctor 123030 10/23/2019
WEST, HAROLD KENNETH JR Supervising Prescribing Practitioner Medical Doctor 36939 10/23/2019
WHEELER, MARERIL Supervising Prescribing Practitioner Medical Doctor 126534 10/23/2019
YORKE, JENNIFER A Supervising Prescribing Practitioner Osteopathic Physician 13134 10/24/2019
YOUNG, VICTOR CHANCE Supervising Prescribing Practitioner Osteopathic Physician 8339 10/24/2019
ZAYAS MALDONADO, DAY ONILL Supervising Prescribing Practitioner Medical Doctor 131573 10/23/2019

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date
BIGGS, FREDERICK SCOTT Prescribing Physician Assistant Physician Assistant 9103660 7/24/2021
GREENE, RICHARD MICHAEL Prescribing Physician Assistant Physician Assistant 9106015 7/24/2021
JOHNSON, IAN JAMES Prescribing Physician Assistant Physician Assistant 9110730 7/24/2021
LEBLANC, JILL ELIZABETH Prescribing Physician Assistant Physician Assistant 9114533 7/24/2021
MILLER, LISA ANN Prescribing Physician Assistant Physician Assistant 9102983 7/24/2021
VOGT, JASON M Prescribing Physician Assistant Physician Assistant 9107868 7/24/2021

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner



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.