License Verification

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SANDRA C MAIDWELL

License Number: PA9105482

Data As Of 11/21/2024

Profession
Physician Assistant
License
PA9105482
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
06/17/2010
Address of Record
12331 McGregor Palms Drive
FORT MYERS, FL 33908
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
636 Del Prado Blvd S CAPE CORAL HOSPITAL
CAPE CORAL, FL 33990
Address
13681 Doctors Way GULF COAST MEDICAL CENTER
FT MYERS, FL 33912
Name Relationship Profession License Effective Date
GIRONDA, VALERIE MARIA Supervising Prescribing Practitioner Medical Doctor 121103 03/04/2024
HENDRIX, TIMOTHY WAYNE Supervising Dispensing Practitioner Medical Doctor 65142 10/02/2017
MAHADEVAN, ANAND RAJ M D Supervising Prescribing Practitioner Medical Doctor 86995 06/08/2017
VICTOR, DARLYN Supervising Prescribing Practitioner Medical Doctor 127702 06/08/2017

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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.


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