License Verification

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GUERDA ETIENNE

License Number: PA9103734

Data As Of 6/23/2024

Profession
Physician Assistant
License
PA9103734
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
05/26/2006
Address of Record
641 US HWY 17-92 WEST
UNIT 631B
HAINES CITY, FL 33844
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
3215 Winter Lake Rd
LAKELAND, FL 33803
Address
3215 WINTER LAKE RD. POLK COUNTY SCHOOL BOARD EMPLOYEE HEALTH CLINIC
LAKELAND, FL 33803
Name Relationship Profession License Effective Date
TAFUR, ANGEL ERNESTO Supervising Dispensing Practitioner Medical Doctor 73896 04/22/2020
TAFUR, ANGEL ERNESTO Supervising Prescribing Practitioner Medical Doctor 73896 04/22/2020

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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 6/23/2024



* 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.