License Verification

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ALLISON RICHELLE MENDENHALL

License Number: PA9111410

Data As Of 12/23/2024

Profession
Physician Assistant
License
PA9111410
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
07/23/2018
Address of Record
350 Clyde Morris Blvd
DAYTONA BEACH, FL 32114
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
239 N. RIDGEWWOD AVE FLORIDA HEALTH CARE PLANS
EDGEWATER, FL 32132
Address
740 DUNLAWTON AVE FLORIDA HEALTH CARE PLANS
PORT ORANGE, FL 32127
Address
1340 RIDGEWOOD AVE FLORIDA HEALTH CARE PLANS
DAYTONA BEACH, FL 32117
Address
320 NORTH CLYDE MORRIS BLVD FLORIDA HEALTH CARE PLANS
DAYTONA BEACH, FL 32114
Address
309 PALM COAST PKWY FLORIDA HEALTH CARE PLANS
PALM COAST, FL 32137
Address
315 PALM COAST PKWY FLORIDA HEALTH CARE PLANS
PALM COAST, FL 32137
Address
937 N SPRING GARDENS AVE FLORIDA HEALTH CARE PLANS
ORANGE CITY, FL 32763
Address
461 N NOVA RD FLORIDA HEALTH CARE PLANS
ORMOND BEACH, FL 32174
Name Relationship Profession License Effective Date
BLACK, HARRY HUNTLEY M D Supervising Prescribing Practitioner Medical Doctor 48766 11/26/2019
GRIGG, JOHNSIE CAROL Supervising Prescribing Practitioner Medical Doctor 47294 10/29/2018
LE, ELIZABETH ANN Supervising Prescribing Practitioner Medical Doctor 99663 10/29/2018

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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 12/23/2024



* 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.