License Verification

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MELODY MATHEW

License Number: PA9112817

Data As Of 11/22/2024

Profession
Physician Assistant
License
PA9112817
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
12/04/2019
Address of Record
12902 USF Magnolia Drive
Moffitt Cancer Center
TAMPA, FL 33612
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
BOURNE, JENNIFER RENEE Supervising Prescribing Practitioner Medical Doctor 159837 05/15/2024
DANAN, DEEPA Supervising Prescribing Practitioner Medical Doctor 127503 09/05/2023
MCMULLEN, CAITLIN Supervising Prescribing Practitioner Medical Doctor 132691 01/09/2023
OTTO, KRISTEN JOHNSON Supervising Prescribing Practitioner Medical Doctor 113364 01/12/2023
PADHYA, TAPAN ASHVIN Supervising Prescribing Practitioner Medical Doctor 82689 05/15/2024
WADSWORTH, J TRAD Supervising Prescribing Practitioner Medical Doctor 129920 06/26/2023

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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



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** 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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