License Number: MA83344Data As Of 2/6/2023
|License Expiration Date||8/31/2021|
|License Original Issue Date||09/06/2016|
|Address of Record||If further information is needed, please contact the Department of Health at (850) 488-0595.|
|Discipline on File||Yes|
The information on this page is a secure, primary source for license verification provided by the Florida Department of Health, Division of Medical Quality Assurance. This website is maintained by Division staff and is updated immediately upon a change to our licensing and enforcement database.