License Verification

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ALISSA JAN SHAVALIER

License Number: PA9103314

Data As Of 5/3/2024

Profession
Physician Assistant
License
PA9103314
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
06/14/2005
Address of Record
350 7TH STREET NORTH
NORTH COLLIER HOSPITAL, NCH HEATHCARE
NAPLES, FL 34102
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
11190 HEALTH PARK BLVD. NORTH COLLIER HOSPITAL NCH HEALTHCARE
NAPLES, FL 34110
Address
40 HEATHWOOD DRIVE MARCO ISLAND URGENT CARE
MARCO ISLAND, FL 34145
Address
15420 COLLIER BLVD. NCH NORTHEAST CAMPUS FREESTANDING EMERGENCY ROOM
NAPLES, FL 34120
Address
24040 South Tamiami Trail NCH Bonita Freestanding Emergency Room
BONITA SPRINGS, FL 34134
Name Relationship Profession License Effective Date
BISHOP, TRACY MARIE Supervising Prescribing Practitioner Osteopathic Physician 16617 10/01/2023
CHAMBERS, JESSICA Supervising Prescribing Practitioner Osteopathic Physician 15853 10/16/2019
CONKLU, EMRE MEHMET Supervising Prescribing Practitioner Osteopathic Physician 10121 10/01/2023
CRUM, MICHAEL Supervising Prescribing Practitioner Medical Doctor 140288 10/16/2019
ESPOSITO, TRAVIS Supervising Prescribing Practitioner Osteopathic Physician 19784 10/01/2023
FRIEDMAN, JOEL Supervising Prescribing Practitioner Medical Doctor 38711 10/01/2023
FRIER, JACOB TROY Supervising Prescribing Practitioner Medical Doctor 141415 10/16/2019
GUFFREY, KATHRYN MARY Supervising Prescribing Practitioner Medical Doctor 137235 10/16/2019
HUMPHRIES, ASHLEY ROSE Supervising Prescribing Practitioner Medical Doctor 160796 10/01/2023
JEN, PETRIJA Supervising Prescribing Practitioner Osteopathic Physician 7864 02/10/2016
KLEIN, JUSTIN BLAKE Supervising Prescribing Practitioner Osteopathic Physician 13685 10/01/2023
KOULIEV, TIMUR Supervising Prescribing Practitioner Medical Doctor 112603 10/16/2019
KRABACHER, KENNETH DANIEL MD Supervising Prescribing Practitioner Medical Doctor 129897 10/16/2019
KUMETZ, CHRISTOPHER ALEXEI Supervising Prescribing Practitioner Medical Doctor 135191 10/16/2019
LE, TRUNG Supervising Prescribing Practitioner Medical Doctor 154049 10/01/2023
LEE, JULIA SUN MD Supervising Prescribing Practitioner Medical Doctor 111060 10/16/2019
LEWIS, JOHN PATRICK Supervising Prescribing Practitioner Medical Doctor 65873 10/01/2023
LYNCH, TAYLOR Supervising Prescribing Practitioner Medical Doctor 160593 10/01/2023
MACIAN, DIANA MARIA Supervising Prescribing Practitioner Medical Doctor 127444 10/16/2019
MARITATO, CHRISTOPHER JOHN Supervising Prescribing Practitioner Osteopathic Physician 8219 10/16/2019
MIAN, USMAN TARIQ Supervising Prescribing Practitioner Medical Doctor 128350 10/16/2019
PATTERSON, SHAWN CHRISTOPHER Supervising Prescribing Practitioner Medical Doctor 116648 09/25/2023
RAMOS, VICTOR A Supervising Prescribing Practitioner Medical Doctor 136925 10/16/2019
VIOLARIS, JOSEPH Supervising Prescribing Practitioner Medical Doctor 140807 10/16/2019
WIEGERS, EDWARD III Supervising Prescribing Practitioner Osteopathic Physician 14844 10/16/2019
WIETECHA, KATHERINE MARGARET Supervising Prescribing Practitioner Medical Doctor 158560 10/01/2023

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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 5/3/2024



* 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.