License Verification

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GINA MEDEA CIPOLLINA

License Number: PA9106991

Data As Of 11/23/2024

Profession
Physician Assistant
License
PA9106991
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
11/15/2012
Address of Record
4500 SAN PABLO ROAD
DEPARTMENT OF TRANSPLANTATION
JACKSONVILLE, FL 32224
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
BURNS, JUSTIN MICHAEL Supervising Prescribing Practitioner Medical Doctor 105200 01/22/2021
CLENDENON, JACOB NATHAN Supervising Prescribing Practitioner Medical Doctor 145251 01/22/2021
CROOME, KRISTOPHER PATRICK Supervising Prescribing Practitioner Medical Doctor 119329 01/21/2021
MAO, SHENNEN ASHLEY Supervising Prescribing Practitioner Medical Doctor 137722 09/28/2018
NGUYEN, JUSTIN HUNG Supervising Prescribing Practitioner Medical Doctor 76404 01/21/2021
PERRY, DANA KAY Supervising Prescribing Practitioner Medical Doctor 104325 01/22/2021

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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 11/23/2024



* 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.