License Verification

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KELLY KRIKLAVA

License Number: PA9111155

Data As Of 12/24/2024

Profession
Physician Assistant
License
PA9111155
License Status
DELINQUENT/
Qualifications
Prescribing
License Expiration Date
1/31/2024
License Original Issue Date
03/05/2018
Address of Record
877 Jefferson Ave
MEMPHIS, TN 38103
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
BROOKS, JAMES DAVID Supervising Prescribing Practitioner Medical Doctor 134600 09/13/2019
FOLLWELL, RICHARD O Supervising Prescribing Practitioner Osteopathic Physician 11914 08/10/2018
GARRETT, ROBERT WOODHOUSE Supervising Prescribing Practitioner Medical Doctor 60290 08/10/2018
LOPES, GUSTAVO AUGUSTO Supervising Prescribing Practitioner Osteopathic Physician 10182 08/10/2018
MOYER, PHILIP WESLEY Supervising Prescribing Practitioner Medical Doctor 102679 07/17/2019
OWINGS, ERIC WILLIAM Supervising Prescribing Practitioner Medical Doctor 131183 07/17/2019
PEEBLES, MATTHEW NELSON Supervising Prescribing Practitioner Medical Doctor 77690 07/17/2019
RITTERSBACH, GEORGE HAROLD JR Supervising Prescribing Practitioner Medical Doctor 54997 07/17/2019
SLAVENS, MICHAEL TEDFORD MD Supervising Prescribing Practitioner Medical Doctor 93774 07/17/2019

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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 12/24/2024



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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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