License Verification

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MACKENZIE LYNN EVANS

License Number: PA9116290

Data As Of 1/12/2026

Profession
Physician Assistant
License
PA9116290
License Status
Clear/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
08/16/2022
Address of Record
12902 USF Magnolia Dr
TAMPA, FL 33612
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
10901 McKinley Dr
TAMPA, FL 33612
Name Relationship Profession License Effective Date
AHMED, ALTAN FAREED Supervising Prescribing Practitioner Medical Doctor 135276 12/12/2023
AL-ROUBAIE, MUSTAFA Supervising Prescribing Practitioner Medical Doctor 158621 12/02/2023
CHOI, JUNSUNG Supervising Prescribing Practitioner Medical Doctor 63922 12/12/2023
EL-HADDAD, GHASSAN ELIAS Supervising Prescribing Practitioner Medical Doctor 113463 12/12/2023
GUSTAINYTE, VAIVA Supervising Prescribing Practitioner Osteopathic Physician 14612 12/12/2023
KIS, BELA Supervising Prescribing Practitioner Medical Doctor 113401 12/12/2023
KOCHARYAN, HAKOB Supervising Prescribing Practitioner Medical Doctor 157442 12/12/2023
NANDA, PAUL KALRA Supervising Dispensing Practitioner Medical Doctor 117861 10/13/2023
NANDA, PAUL KALRA Supervising Prescribing Practitioner Medical Doctor 117861 10/13/2023
PARIKH, NAINESH SHARAD Supervising Prescribing Practitioner Medical Doctor 128082 12/12/2023
SALLOUM, ELIAS HABIB Supervising Prescribing Practitioner Medical Doctor 143403 12/12/2023
VENKAT, SHREE RAMANAN DR Supervising Prescribing Practitioner Medical Doctor 116495 08/05/2024

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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 1/12/2026



* 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.