KATRINA DIONNE BLACK
License Number: PA9110311
Data As Of 6/22/2024
Profession | Physician Assistant | |
---|---|---|
License | PA9110311 | |
License Status | CLEAR/Active | |
Qualifications | Dispensing Practitioner | Prescribing |
License Expiration Date | 1/31/2026 | |
License Original Issue Date | 04/05/2017 | |
Address of Record | 5040 US HWY 98 N | |
Concentra Medical Center | ||
LAKELAND, FL 33809 | ||
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain) | No | |
Discipline on File | No | |
Public Complaint | No |
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