License Verification

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JACLYN LORI MASCARIN

License Number: PA9107043

Data As Of 11/21/2024

Profession
Physician Assistant
License
PA9107043
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
01/08/2013
Address of Record
300 PINELLAS ST
CLEARWATER, FL 33756
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
8839 BRYAN DAIRY RD. BARDMOOR EMERGENCY CENTER
LARGO, FL 33777
Address
3231 McMullen Booth Rd
SAFETY HARBOR, FL 34695
Address
601 Main st
DUNEDIN, FL 34698
Name Relationship Profession License Effective Date
WALDREP, NATHAN KEITH Supervising Prescribing Practitioner Medical Doctor 58834 04/21/2020

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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.


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.