License Verification

Printer Friendly Version

BRADLEE BROOKE FAGERBERG

License Number: AA535

Data As Of 11/16/2024

Profession
Anesthesiologist Assistant
License
AA535
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
09/13/2019
Address of Record
1586 Long Spur
Apt 102
ODESSA, FL 33556
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
AHMAD SABRY, MOHAMMAD HAZEM IBRAHIM SUPERVISOR for AA Medical Doctor 94963 02/27/2023
CHUNG, JASON HYUN MD SUPERVISOR for AA Medical Doctor 104807 01/06/2023
CRUZ, JAIME BENJAMIN SUPERVISOR for AA Medical Doctor 90943 10/31/2022
FONTENOT, ROY JOSEPH SUPERVISOR for AA Medical Doctor 141689 01/02/2023
FOROUSH, PEJMAN SUPERVISOR for AA Medical Doctor 136407 10/27/2022
IDREES, ALI AYAZ SUPERVISOR for AA Medical Doctor 145354 03/20/2023
MANOHARAN, PRASAD GOVINDARAJ SUPERVISOR for AA Medical Doctor 133099 12/02/2022
NGUYEN, HAI CONG SUPERVISOR for AA Medical Doctor 110160 12/05/2022
PAYAPPAGOUDAR, GURUBASANAGOUDA V SUPERVISOR for AA Medical Doctor 107461 02/13/2023
ROACH, MICHELLE ANN SUPERVISOR for AA Medical Doctor 117302 11/02/2022

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 11/16/2024



* 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.