License Verification

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PATRICK BALLARD

License Number: OS20852

Data As Of 9/28/2024

Profession
Osteopathic Physician
License
OS20852
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
3/31/2026
License Original Issue Date
03/22/2024
Address of Record
2299 Oakmont Dr
#2206
SIERRA VISTA, AZ 85635
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

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Name Relationship Profession License Effective Date
BANERJEE, PUSHPAL R Prescribing Physician Assistant Osteopathic Physician 8141 6/12/2024
GLAZER, KELLY SYLVIA Prescribing Physician Assistant Medical Doctor 149363 6/12/2024
HULTZ, CINTIA HENRIQUES Prescribing Physician Assistant Physician Assistant 9109327 6/12/2024
JOHNSON, IAN JAMES Prescribing Physician Assistant Physician Assistant 9110730 6/12/2024
MILLER, LISA ANN Prescribing Physician Assistant Physician Assistant 9102983 6/12/2024
NOTMAN, BRITTANY RENEE Prescribing Physician Assistant Physician Assistant 9107171 6/12/2024

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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 9/28/2024



* 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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