License Verification

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MICHAEL BLAKE WHITE

License Number: ME40427

Data As Of 11/22/2024

Profession
Medical Doctor
License
ME40427
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2025
License Original Issue Date
07/15/1982
Address of Record
955 Village Medical
South Winter Park Dr.
CASSELBERRY, FL 32707
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
BRAUTIGAN, FREDERICK BRIAN Supervising Prescribing Practitioner Medical Doctor 117546 01/10/2024
DAVIS, RANDAL LEE Supervising Prescribing Practitioner Medical Doctor 110579 09/16/2022

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Name Relationship Profession License Effective Date
NEZOWITZ, GREGG DAVID Subordinate Medical Doctor 75671 6/16/2021
PLEASANTS, TOM ADAIR Subordinate Osteopathic Physician 5751 10/15/2020
SIZEMORE, SULE Dispensing Physician Assistant Physician Assistant 9110643 5/22/2020
SIZEMORE, SULE Prescribing Physician Assistant Physician Assistant 9110643 5/22/2020
TKACZYK, BLISS CARLEY Dispensing Physician Assistant Physician Assistant 9112344 10/8/2019
TKACZYK, BLISS CARLEY Prescribing Physician Assistant Physician Assistant 9112344 10/8/2019

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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.


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.