License Verification

Printer Friendly Version

KATHRYN TYRRELL DEGOURSEY PA-C

License Number: PA1974

Data As Of 4/24/2025

Profession
Physician Assistant
License
PA1974
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
10/12/1988
Address of Record
10058 BayMeadows Road
JACKSONVILLE, FL 32256
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
3550 University Blvd S. Su302 BakerGilmour Cardiovascular
JAX, FL 32224
Name Relationship Profession License Effective Date
AHMED, FARID Supervising Prescribing Practitioner Medical Doctor 100221 05/01/2020
BENNETT, JOHNIQUE CORTA Supervising Prescribing Practitioner Medical Doctor 136292 05/01/2020
GREENE, TREVOR ORVILLE Supervising Prescribing Practitioner Medical Doctor 89472 03/01/2017
GUPTA, AMIT KUMAR Supervising Prescribing Practitioner Medical Doctor 136345 03/19/2020
IMAM, HUSSAIN SYED Supervising Prescribing Practitioner Medical Doctor 81517 05/01/2020
IMAM, TALAT Supervising Prescribing Practitioner Medical Doctor 71382 05/02/2020
PEREIRA, EDWARD SCOTT Supervising Prescribing Practitioner Medical Doctor 94160 03/01/2017

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner

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 4/24/2025



* 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.