License Verification

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STEFANIE MARIE INDELLICATI

License Number: PA9109630

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9109630
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
07/05/2016
Address of Record
120 S OLIVE AVE
UNIT 116
WEST PALM BEACH, FL 33401
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
5245 41st street
VERO BEACH, FL 32967
Address
2200 virginia ave
FORT PIERCE, FL 34950
Address
3100 coral hills drive suite 207
CORAL SPRINGS, FL 33065
Address
1680 SE Lyngate Drive
PORT SAINT LUCIE, FL 34952
Address
4425 Burns Road
PALM BEACH GARDENS, FL 33410
Name Relationship Profession License Effective Date
COOPERSTEIN, GARY ALAN Supervising Prescribing Practitioner Osteopathic Physician 15659 07/23/2020
PIERRILUS, JEDLYN Supervising Dispensing Practitioner Medical Doctor 125995 02/20/2018
PIERRILUS, JEDLYN Supervising Prescribing Practitioner Medical Doctor 125995 02/20/2018

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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.