License Verification

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HOLLIE JO HICKMAN

License Number: OS9337

Data As Of 11/22/2024

Profession
Osteopathic Physician
License
OS9337
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
3/31/2026
License Original Issue Date
08/31/2004
Address of Record
209 PONTE VEDRA PARK DRIVE
PONTE VEDRA BEACH, FL 32082
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
4866 Big Island Drive #5 Ideal Image
JACKSONVILLE, FL 32246
Address
5472 First Coast Highway #3
FERNANDINA BEACH, FL 32034
Address
480 Town Plaza Ave #150
PONTE VEDRA, FL 32081
Address
11512 Lake Mead Avenue #513
JACKSONVILLE, FL 32256
Address
304 Ashourian Ave Unit 107
ST AUGUSTINE, FL 32092
Address
314 Paseo Reyes Dr. St.
ST AUGUSTINE, FL 32095
Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
OLDENBURG, KATELYN ELIZABETH Prescribing Physician Assistant Physician Assistant 9106063 1/19/2024
SPARROW, TIFFANY MOMOKO Prescribing Physician Assistant Physician Assistant 9116575 11/11/2022

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 11/22/2024



* 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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