License Verification

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GREGORY ALAN FENN

License Number: PA9108811

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9108811
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
07/14/2015
Address of Record
1 Shircliff Way
JACKSONVILLE, FL 32204
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1580 BRANAN FIELD ROAD ST VINCENTS MEDICAL CENTER CLAY COUNTY
MIDDLEBURG, FL 32068
Address
1 SHIRCLIFF WAY ST VINCENTS MEDICAL CENTER RIVERSIDE
JACKSONVILLE, FL 32204
Address
1670 St. Vincent's Way
MIDDLEBURG, FL 32068
Address
1670 ST. VINCENT'S WAY
MIDDLEBURG, FL 32068
Address
1580 Branan Field Road
MIDDLEBURG, FL 32068
Name Relationship Profession License Effective Date
AIELLO, JAMES JOHN Supervising Prescribing Practitioner Medical Doctor 113843 09/24/2018
AUGENSTEIN, W LYNN MD Supervising Prescribing Practitioner Medical Doctor 55214 09/24/2018
DIETRICH, WILLIAM GERARD MD Supervising Prescribing Practitioner Medical Doctor 55253 09/24/2018
FINKLEA, TERI LYNN Supervising Prescribing Practitioner Medical Doctor 115273 09/24/2018
HAROLD, KELVIN JAMES Supervising Prescribing Practitioner Medical Doctor 122392 09/24/2018
HOIDA, JEFFREY SCOTT MD Supervising Prescribing Practitioner Medical Doctor 136257 09/24/2018
HOIDA, SHIELDS DUSS Supervising Prescribing Practitioner Medical Doctor 125526 04/17/2019
JARAMILLO, DAVID HERNANDO Supervising Prescribing Practitioner Medical Doctor 96063 09/24/2018
JOHNSTONE, CHRISTINE LYN Supervising Prescribing Practitioner Medical Doctor 97925 09/24/2018
KINMAN, ISAAC MITCHELL Supervising Prescribing Practitioner Osteopathic Physician 15575 06/28/2019
LUCEY, PAUL D MD Supervising Prescribing Practitioner Medical Doctor 50050 09/24/2018
MANTHA, KALYAN C Supervising Prescribing Practitioner Medical Doctor 122523 09/24/2018
MCBRIDE JOHNSON, ERIN RUTH Supervising Prescribing Practitioner Medical Doctor 110283 09/24/2018
MOIR, PAUL A Supervising Prescribing Practitioner Medical Doctor 76950 09/24/2018
MYHRER, ERIK Supervising Prescribing Practitioner Medical Doctor 96634 09/24/2018
PETERSON, MICHAEL DAVID Supervising Prescribing Practitioner Osteopathic Physician 13490 09/24/2018
REZNICSEK, DANIELLE RENEE MD Supervising Prescribing Practitioner Medical Doctor 85463 09/24/2018
SAPOLSKY, JEFFREY HOWARD MD Supervising Prescribing Practitioner Medical Doctor 68324 09/24/2018
SCHARE, ANDREW IRA Supervising Prescribing Practitioner Medical Doctor 80137 10/04/2023
SHAH, MICHAEL Supervising Prescribing Practitioner Medical Doctor 127108 09/24/2018
SHARP, PHILIP R Supervising Prescribing Practitioner Medical Doctor 22975 09/24/2018
STERKA, DAVID GEORGE JR Supervising Prescribing Practitioner Medical Doctor 125380 09/24/2018
VIHLEN, ANDREW SCOTT Supervising Prescribing Practitioner Medical Doctor 109676 09/24/2018

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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 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.