License Verification

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PATRICK ROSS THOMPSON

License Number: PA9102388

Data As Of 6/25/2024

Profession
Physician Assistant
License
PA9102388
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
05/12/2003
Address of Record
120 Healthpark Blvd.
Suite #1
ST AUGUSTINE, FL 32086
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
145 City Place Suite 201
PALM COAST, FL 32164
Address
351 Town Plaza Ave. Suite 201
PONTE VEDRA, FL 32081
Name Relationship Profession License Effective Date
GAY, DAVID MATTHEW Supervising Prescribing Practitioner Medical Doctor 105484 02/26/2021
PUTNEY, SCOTT ALEXANDER Supervising Prescribing Practitioner Medical Doctor 127463 03/03/2021
ROSENBAUM, COREY SAMUEL Supervising Prescribing Practitioner Osteopathic Physician 13280 03/02/2021
SUHEY, PAUL VINCENT DO Supervising Prescribing Practitioner Osteopathic Physician 5823 03/09/2021

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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 6/25/2024



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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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