License Verification

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ANDREA MICHELLE CHAPUT

License Number: PA9105370

Data As Of 11/21/2024

Profession
Physician Assistant
License
PA9105370
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
01/21/2010
Address of Record
1000 Mar Walt Dr
FT WALTON BEACH, FL 32547
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
700 W Oak Street
KISSIMMEE, FL 34741
Name Relationship Profession License Effective Date
HENDRIX, TIMOTHY WAYNE Supervising Dispensing Practitioner Medical Doctor 65142 08/12/2020

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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.