License Verification

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COURTNEY ANN BLANKENSHIP

License Number: PA9106490

Data As Of 5/19/2024

Profession
Physician Assistant
License
PA9106490
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
03/21/2012
Address of Record
1324 LAKELAND HILLS BLVD.
LAKELAND, FL 33805
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
ABRAHAMSEN, NADIA Supervising Prescribing Practitioner Medical Doctor 108847 02/21/2018
BANERJEE, PUSHPAL R Supervising Prescribing Practitioner Osteopathic Physician 8141 08/01/2021
BRENNER, ANNETTE MAGNANT Supervising Prescribing Practitioner Medical Doctor 70818 02/21/2020
COVITZ, SHANNON MIXON Supervising Prescribing Practitioner Osteopathic Physician 11652 02/21/2020
DELEON, JASON Supervising Prescribing Practitioner Medical Doctor 122537 06/21/2019
DUBEY, JESSE VINCENT Supervising Prescribing Practitioner Osteopathic Physician 13099 06/21/2019
GILLESPIE, RITA MARGARET MARY Supervising Prescribing Practitioner Osteopathic Physician 13077 06/21/2019
JOHN, TESHY VARUGHESE Supervising Prescribing Practitioner Medical Doctor 125364 06/21/2019
LONGO, JENNIFER ANN Supervising Prescribing Practitioner Medical Doctor 113332 11/05/2019
MEMON, SUMERA HAROON Supervising Prescribing Practitioner Osteopathic Physician 11668 06/21/2019
MISDARY, JOHN SARATIAL MD Supervising Prescribing Practitioner Medical Doctor 111957 06/25/2018
PALIGA, ANDREW Supervising Prescribing Practitioner Medical Doctor 111562 06/21/2019
PATEL, TEJAS Supervising Prescribing Practitioner Osteopathic Physician 13790 06/21/2019
REINHARDT, NEIL CHRISTOPHER Supervising Prescribing Practitioner Medical Doctor 69496 11/05/2019
SPENCER, ANDREW JOSEPH Supervising Prescribing Practitioner Medical Doctor 122767 06/21/2019
SUEN, ANDREA CATHERINE Supervising Prescribing Practitioner Medical Doctor 116964 06/21/2019
TICKETT, SHELLEY SMITH Supervising Prescribing Practitioner Medical Doctor 90313 02/21/2018
VYTYKAC, ADAM Supervising Prescribing Practitioner Medical Doctor 115497 06/21/2019
WISER, ROBERT K Supervising Prescribing Practitioner Medical Doctor 139864 02/21/2020
ZACHARIAH, ANISH BABU M D Supervising Prescribing Practitioner Medical Doctor 101413 11/05/2019

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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 5/19/2024



* 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.