License Verification

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JACOB LEE WONDERLICH

License Number: PA9103414

Data As Of 11/24/2024

Profession
Physician Assistant
License
PA9103414
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
07/19/2005
Address of Record
3090 Caruso Court
Suite:20
ORLANDO, FL 32806
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1401 WEST SEMINOLE BLVD CENTRAL FLORIDA REGIONAL HOSPITAL
SANFORD, FL 32771
Address
1414 KUHL AVENUE ORLANDO HEALTH
ORLANDO, FL 32806
Address
1720 SOUTH COOK AVE. EMERGENCY PHYSICIANS OF CENTRAL FLORIDA
ORLANDO, FL 32806
Address
40100 Highway 27 AdventHealth Heart of Florida FKA Heart of Fl Regional Med. Ctr.
DAVENPORT, FL 33837
Address
1706 NORTH SEMORAN BLVD UNIT 100
ORLANDO, FL 32807
Address
7653 Turkey Lake Road
ORLANDO, FL 32819
Name Relationship Profession License Effective Date
ALEXANDER, LARRY LEON Supervising Prescribing Practitioner Medical Doctor 80072 08/01/2021
ARRIAGA-ONEILL, YARITZA MD Supervising Prescribing Practitioner Medical Doctor 111529 08/01/2021
BARLOW, RYAN THOMAS Supervising Prescribing Practitioner Medical Doctor 149752 07/26/2021
BIGGS, FREDERICK SCOTT Supervising Prescribing Practitioner Physician Assistant 9103660 08/01/2021
BRATCHER, MONTEL FRABRECIO Supervising Prescribing Practitioner Medical Doctor 136544 07/29/2021
ECHAGUE COLMAN, RAMON ANTONIO Supervising Prescribing Practitioner Medical Doctor 111476 08/01/2021
FALKOWSKI, ROBERT PAUL SR Supervising Prescribing Practitioner Medical Doctor 60514 08/01/2021
FREELS, KEVIN Supervising Prescribing Practitioner Medical Doctor 131199 08/01/2021
GOINS, DAVID SCOTT Supervising Prescribing Practitioner Physician Assistant 9102736 08/01/2021
JASIMUDDIN, SHEIKH KHWAJA Supervising Prescribing Practitioner Medical Doctor 100463 08/01/2021
LIPSMEYER, CHRISTOPHER PAUL Supervising Prescribing Practitioner Medical Doctor 102475 08/01/2021
MARAVEGIAS, ISMENE NINA Supervising Prescribing Practitioner Medical Doctor 85168 07/23/2021
MCHALE, MICHAEL SHAMUS Supervising Prescribing Practitioner Osteopathic Physician 6360 07/23/2021
OCHS, JEFFREY DWAYNE Supervising Prescribing Practitioner Physician Assistant 9106445 08/01/2021
PAGAN-RIVERA, REY YAMIL Supervising Prescribing Practitioner Medical Doctor 134981 08/01/2021
PRUITT, JAMES ALLEN Supervising Prescribing Practitioner Medical Doctor 142076 08/01/2021
SANTIAGO-APONTE, RAFAEL A Supervising Prescribing Practitioner Medical Doctor 114771 08/16/2021
SHAPIRO, LAUREN Supervising Prescribing Practitioner Medical Doctor 149050 07/01/2021
SHARMA, MIRAND REEB Supervising Prescribing Practitioner Medical Doctor 82852 07/23/2021
VELASCO, ANDRES FELIPE Supervising Prescribing Practitioner Medical Doctor 96936 08/01/2021
WEAVER, LEAH DARE Supervising Prescribing Practitioner Physician Assistant 9103804 08/01/2021

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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 11/24/2024



* 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.