License Verification

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ALEXIS JO BUSHMAN

License Number: PA9110520

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9110520
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
08/02/2017
Address of Record
2020 59th St W, Bradenton
BRADENTON, FL 34209
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1234 SE Magnolia Ext., Unit 1
OCALA, FL 34471
Name Relationship Profession License Effective Date
ALBURAIH, ABDULAZIZ Supervising Prescribing Practitioner Medical Doctor 140682 11/22/2024
CHEN, TAIWEN Supervising Prescribing Practitioner Medical Doctor 125063 11/22/2024
FERDOSIANNAJAFABADI, BEHROUZ Supervising Prescribing Practitioner Medical Doctor 145806 11/22/2024
FERRO, TAMMY N Supervising Prescribing Practitioner Osteopathic Physician 11575 11/22/2024
GOGINENI, ANIL KUMAR Supervising Prescribing Practitioner Medical Doctor 100227 11/22/2024
HAJ OBEID, JACK IBRAHIM Supervising Prescribing Practitioner Medical Doctor 87987 11/22/2024
KOHLI, NAGESH Supervising Prescribing Practitioner Medical Doctor 57687 11/22/2024
MITRA, PURUSHOTTAM Supervising Prescribing Practitioner Medical Doctor 56306 11/22/2024
SEEVARATNAM, ANDREW RANGIEV Supervising Prescribing Practitioner Medical Doctor 106564 11/22/2024
SYMEONIDES, SIMON THEO Supervising Prescribing Practitioner Medical Doctor 84573 11/22/2024

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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.