License Verification

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CLEMENTE WILSON

License Number: PA9100865

Data As Of 4/29/2025

Profession
Physician Assistant
License
PA9100865
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
01/25/1999
Address of Record
7900 NW 33 st. Suite 106-101
JIREH MEDICAL CENTER CORP
HOLLYWOOD, FL 33024
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
7900 NW 33 st. Suite 106-101 JIREH MEDICAL CENTER CORP
HOLLYWOOD, FL 33024
Name Relationship Profession License Effective Date
FERNANDEZ, MARTA ROSA Supervising Prescribing Practitioner Medical Doctor 90692 11/13/2019

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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 4/29/2025



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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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