License Verification

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SUMERA HAROON MEMON

License Number: OS11668

Data As Of 12/22/2024

Profession
Osteopathic Physician
License
OS11668
License Status
CLEAR/Active
License Expiration Date
3/31/2026
License Original Issue Date
04/11/2012
Address of Record
1324 lakeland hills blvd
LAKELAND, FL 33805
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
12950 Racetrack Rd Suite 106
TAMPA, FL 33626
Name Relationship Profession License Effective Date
BARBERA, ANDREW ROBERT Supervising Prescribing Practitioner Medical Doctor 144387 10/01/2020
BARBERA, ANDREW ROBERT Supervisor Medical Doctor 144387 10/15/2020
SPENCER, ANDREW JOSEPH Supervising Prescribing Practitioner Medical Doctor 122767 09/23/2020

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Name Relationship Profession License Effective Date
BAILEY-STULTZ, MAROLDA P Prescribing Physician Assistant Physician Assistant 2031 8/20/2018
BLANKENSHIP, COURTNEY ANN Prescribing Physician Assistant Physician Assistant 9106490 6/21/2019
BRUNO, MARCUS Prescribing Physician Assistant Physician Assistant 9110320 7/23/2018
BUTZ, MELISSA A Prescribing Physician Assistant Physician Assistant 9102275 8/21/2018
CARDWELL, DONALD VINCENT JR Prescribing Physician Assistant Physician Assistant 3619 8/20/2018
COBB WEYAND, ALYSSA CLAIRE Prescribing Physician Assistant Physician Assistant 9109483 9/19/2018
DELCAMP, CHRISTY LASSITER Prescribing Physician Assistant Physician Assistant 9105893 10/4/2018
DUONG-STRICKLAND, DIEN K Prescribing Physician Assistant Physician Assistant 3211 8/20/2018
EVERSOLE, KRISTEN SUSSANNE Prescribing Physician Assistant Physician Assistant 9103496 8/20/2018
HANSON, JULIE KIET Prescribing Physician Assistant Physician Assistant 9105034 10/2/2018
HOARD, MICHAEL RYAN Prescribing Physician Assistant Physician Assistant 9112164 12/5/2019
JOHNSON, JILLIAN PALMER Prescribing Physician Assistant Physician Assistant 9105057 8/21/2018
LEVINE, REBECCA NICOLE Prescribing Physician Assistant Physician Assistant 9112012 11/12/2019
LYNCH, KATIE Prescribing Physician Assistant Physician Assistant 9110528 8/20/2018
MARTIN, SAMANTHA LEIGH Prescribing Physician Assistant Physician Assistant 9113333 9/24/2020
MCCABE, JANET FAITH Prescribing Physician Assistant Physician Assistant 9104602 8/21/2018
MOODY, NANCY C Prescribing Physician Assistant Physician Assistant 2377 8/20/2018
MOORE, ERIN RACHEL Prescribing Physician Assistant Physician Assistant 9111310 12/6/2018
PALMER, BRIAN S Prescribing Physician Assistant Physician Assistant 1779 8/20/2018
PUTNAM, MALLORY MOODY Prescribing Physician Assistant Physician Assistant 9106745 7/19/2018
ROBART, CARRIE Prescribing Physician Assistant Physician Assistant 9113153 6/22/2021
ROESCH, KELLIE CHRISTINE Prescribing Physician Assistant Physician Assistant 9115243 5/18/2023
SELLERS JR, JAMES H Prescribing Physician Assistant Physician Assistant 9104288 9/26/2018
SOTO, STEFANIE Prescribing Physician Assistant Physician Assistant 9109569 9/26/2018
THOMAS, JAMIE LEIGH Prescribing Physician Assistant Physician Assistant 9111031 12/10/2018
WALLACE, NICOLE ELIZABETH Prescribing Physician Assistant Physician Assistant 9103316 8/20/2018
WALLACE, STEVEN GREGORY JR Prescribing Physician Assistant Physician Assistant 9107761 8/20/2018
WILSON, KRISTOPHER DILLON Prescribing Physician Assistant Physician Assistant 9112568 9/24/2020
ZILBERBERG, KACEY SABRA Prescribing Physician Assistant Physician Assistant 9110491 8/9/2018

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/22/2024



* 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.