License Verification

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NIMAE AWANTANG MD

License Number: ME113443

Data As Of 12/22/2024

Profession
Medical Doctor
License
ME113443
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
06/21/2012
Address of Record
2601 BAYTREE CT
PANAMA CITY, FL 32405
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
915 East Fairfield Drive
PANAMA CITY, FL 32503
Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
BLAICH, PHILLIP WAYNE Prescribing Physician Assistant Physician Assistant 9103668 4/23/2019
BOXBERGER, LEE ALLEN Dispensing Physician Assistant Physician Assistant 9108451 6/2/2020
BOXBERGER, LEE ALLEN Prescribing Physician Assistant Physician Assistant 9108451 6/5/2020
KIMBLE, TIFFANY ANNE Prescribing Physician Assistant Physician Assistant 9105875 3/3/2022
PEREZ, CHRISTY ANNE Prescribing Physician Assistant Physician Assistant 9112855 4/4/2022
PUTMAN, LESLIE SUE Prescribing Physician Assistant Physician Assistant 3042 3/3/2022

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Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner



No Continuing Education Hours Received from Approved Providers As Of 12/23/2024



* 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.


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