License Verification

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JAMES SMRTIC

License Number: PA9110342

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9110342
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
04/20/2017
Address of Record
Drs. Mori, Bean and Brooks
8375 Dix Ellis Trail Suite 201
JACKSONVILLE, FL 32256
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
2001 Kingsley Avenue
ORANGE PARK, FL 32073
Address
14550 St. Augustine Road
JACKSONVILLE, FL 32258
Address
800 Prudential Drive
JACKSONVILLE, FL 32207
Address
1235 San Marco Blvd
JACKSONVILLE, FL 32207
Address
3625 University Blvd. S
JACKSONVILLE, FL 32216
Address
1350 13th Avenue South
JACKSONVILLE BEACH, FL 32250
Address
3599 University Blvd., S
JACKSONVILLE, FL 32216
Name Relationship Profession License Effective Date
ALSAHLI, HAITHAM Supervising Prescribing Practitioner Medical Doctor 140232 08/28/2019
BEARDSLEY, SHANNON LEE Supervising Prescribing Practitioner Medical Doctor 70257 07/18/2022
CUNNINGHAM, JAMES CHRISTOPHER Supervising Prescribing Practitioner Osteopathic Physician 10705 08/28/2019
GORDON, PATRICK OWEN Supervising Prescribing Practitioner Medical Doctor 63840 02/06/2019
JOHN, CHRISTOPHER M Supervising Prescribing Practitioner Osteopathic Physician 15940 08/28/2019
JOHNSON, CHARLES EDWARD Supervising Prescribing Practitioner Medical Doctor 110710 10/28/2022
LAHIJI, KIAN Supervising Prescribing Practitioner Medical Doctor 136700 02/06/2019
ROURA, DANIEL Supervising Prescribing Practitioner Medical Doctor 133446 02/06/2019
TERHAAR, KENNETH Supervising Prescribing Practitioner Medical Doctor 134708 03/18/2019

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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



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** 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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