License Verification

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JONATHAN DAVID DOMICO

License Number: PA9104899

Data As Of 11/21/2024

Profession
Physician Assistant
License
PA9104899
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
01/07/2009
Address of Record
3231 N McMullen Booth Rd
SAFETY HARBOR, FL 34695
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
2600 Westhall Lane AdventHealth Centra Care
MAITLAND, FL 32751
Address
6600 MADISON STREET MORTON PLANT NORTH BAY HOSPITAL
NEW PORT RICHEY, FL 34652
Address
8839 Bryan Dairy Road Morton Plant Mease Bardmoor Emerg. Ctn.
LARGO, FL 33777
Address
300 Pinellas Street Morton Plant Mease Bardmoor Emerg. Dept.
CLEARWATER, FL 33756
Name Relationship Profession License Effective Date
HENDRIX, TIMOTHY WAYNE Supervising Dispensing Practitioner Medical Doctor 65142 08/14/2020

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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 11/21/2024



* 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.