License Verification

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License Number: AA835

Data As Of 9/28/2024

Profession
Anesthesiologist Assistant
License
AA835
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
09/11/2023
Address of Record
5011 Beland Drive
Lake Worth
LAKE WORTH, FL 33467
Discipline on File
No
Public Complaint
No
Address
62 Columbia Street OH Jewet tOrtho Insti
ORLANDO, FL 32806
Name Relationship Profession License Effective Date
ABDUL, FIRAS SALEH SUPERVISOR for AA Medical Doctor 109007 01/03/2023
FONG, TYLER SUPERVISOR for AA Medical Doctor 151110 07/24/2023
FORD, MARIKO SUPERVISOR for AA Medical Doctor 145119 07/24/2023
MCKILLEN, JULIA BASKIN SUPERVISOR for AA Medical Doctor 154797 07/01/2023
SHAH, NIPA ROHITKUMAR SUPERVISOR for AA Medical Doctor 108963 04/05/2023
VANALLEN, KARY LAMARR SUPERVISOR for AA Medical Doctor 77302 01/03/2023
VOSE, STEPHEN OLIVER SUPERVISOR for AA Medical Doctor 119601 05/22/2023
WALKER, SHERYL MD SUPERVISOR for AA Medical Doctor 92373 04/03/2023

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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 9/28/2024



* 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.