License Verification

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RUSTIN GERALD SORENSEN

License Number: PA9101453

Data As Of 10/27/2026

Profession
Physician Assistant
License
PA9101453
License Status
Clear/Active
Qualifications
Prescribing
License Expiration Date
1/31/2028
License Original Issue Date
10/02/2000
Address of Record
1034 Marwalt Dr
FT WALTON BEACH, FL 32547
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
5300S Ferdon Blvd
CRESTVIEW, FL 32536
Address
D 554 Twin Cities Blvd
NICEVILLE, FL 32578
Address
3101 36474C Emerald Coast Pkwy destin
DESTIN, FL 32541
Name Relationship Profession License Effective Date
DONCHEY, STEVEN SCOTT MD Supervising Prescribing Practitioner Medical Doctor 60265 10/21/2026
FOX, THOMAS MICHAEL DO Supervising Prescribing Practitioner Osteopathic Physician 6530 10/21/2026
GOEKE, BRADLEY J Supervising Prescribing Practitioner Medical Doctor 111350 10/21/2026
MARKOWSKI, WILLIAM JOSEPH Supervising Prescribing Practitioner Medical Doctor 70428 10/21/2026

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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 10/28/2026



* 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.


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