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CHANCELLOR FOLSOM GRAY

License Number: ME124154

Data As Of 12/22/2024

Profession
Medical Doctor
License
ME124154
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2025
License Original Issue Date
05/13/2015
Address of Record
7540 W University Avenue
GAINESVILLE, FL 32607
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
2118 SW 20TH PL UNIT 102
OCALA, FL 34471
Name Relationship Profession License Effective Date
GRAY, CHANCELLOR FOLSOM Supervising Prescribing Practitioner Medical Doctor 124154 01/03/2024
PARVATANENI, HARI KIRAN Supervising Prescribing Practitioner Medical Doctor 98295 01/03/2024

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Name Relationship Profession License Effective Date
ABOUREZK, MOLLY DUMFORD Prescribing Physician Assistant Physician Assistant 9115615 6/28/2022
BROMBACHER O'CONNELL, STEPHANIE RENEE Prescribing Physician Assistant Physician Assistant 9108799 1/3/2024
GONZALEZ, JAVIER Prescribing Physician Assistant Physician Assistant 9119274 10/1/2024
GRAY, CHANCELLOR FOLSOM Prescribing Physician Assistant Medical Doctor 124154 1/3/2024
PRUITT, CHASE THOMAS Prescribing Physician Assistant Physician Assistant 9116117 8/25/2022

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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.