License Verification

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JACOB OLIVER KING CONNELLY

License Number: ME144380

Data As Of 9/6/2026

Profession
Medical Doctor
License
ME144380
License Status
Clear/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2028
License Original Issue Date
02/28/2020
Address of Record
1050 SE Monterey Road
Suite 400
STUART, FL 34994
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
9401 SW Discovery Way SUITE 201
PORT SAINT LUCIE, FL 34987
Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
AVIDON, PAUL I Prescribing Physician Assistant Physician Assistant 1609 8/1/2026
BARNEWOLD, KEVIN FRANCIS Prescribing Physician Assistant Physician Assistant 9102603 8/1/2026
BUSSOM, SCOTT Prescribing Physician Assistant Physician Assistant 9114250 8/1/2026
COBB, TARA ANN Prescribing Physician Assistant Physician Assistant 9101659 8/1/2026
HOLSCHWANDER, DAMIAN Prescribing Physician Assistant Physician Assistant 9117363 8/1/2026
MATHEW, ROYCE THOMAS Prescribing Physician Assistant Physician Assistant 9112762 8/1/2026
MCGANNON, ANDREA NICOLE Prescribing Physician Assistant Physician Assistant 9116067 3/12/2024
OKOLICHANY, RANDALL EDWARD Prescribing Physician Assistant Physician Assistant 9113556 8/1/2026
SHORTRIDGE, JENNA ELIZABETH Prescribing Physician Assistant Physician Assistant 9120905 10/1/2025
VAN KEUREN, AARON Prescribing Physician Assistant Physician Assistant 9120983 10/27/2025

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Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner



No Continuing Education Hours Received from Approved Providers As Of 9/6/2026



* 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.