License Verification

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MARC SANTAMBROSIO

License Number: OS8725

Data As Of 11/25/2024

Profession
Osteopathic Physician
License
OS8725
License Status
CLEAR/Active
License Expiration Date
3/31/2026
License Original Issue Date
06/10/2002
Address of Record
500 WIDERLEY PL
SUITE 115
MAITLAND, FL 32751
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
2465 Guidewell North orange blossom trail
KISSIMMEE, FL 34744
Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
BURCHENSON, KRYSTA-GAYE LATOYA Prescribing Physician Assistant Physician Assistant 9108009 3/27/2018
GRAHAM, KELLY ANN Prescribing Physician Assistant Physician Assistant 9112573 10/24/2019
HABIB, LAILA NICOLE Prescribing Physician Assistant Physician Assistant 9111509 12/17/2018
LUKASIK, MICHELLE NICOLE Prescribing Physician Assistant Physician Assistant 9111603 12/19/2018
MACKENZIE, WILLIAM CARL Prescribing Physician Assistant Physician Assistant 9112545 10/9/2019
ROMERO, MARVIN JESUS Office Surgery Center Osteopathic Physician 12137 3/4/2022

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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 11/25/2024



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** 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.


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