License Verification

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MARIJO BILITSKI

License Number: PA9114430

Data As Of 11/22/2024

Profession
Physician Assistant
License
PA9114430
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
05/24/2021
Address of Record
Bayside Urgent Care Center
1001 S Fort Harrison Ave
Suite 101
CLEARWATER, FL 33756
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
CORIS, ERIC EMMANUEL MD Supervising Prescribing Practitioner Medical Doctor 74220 05/02/2022
WALLACE, RICHARD PETERKIN Supervising Dispensing Practitioner Medical Doctor 85690 07/17/2023
WALLACE, RICHARD PETERKIN Supervising Prescribing Practitioner Medical Doctor 85690 07/17/2023

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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



* 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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