License Verification

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ANDREW DAVID BOLTUCH

License Number: OS15092

Data As Of 12/22/2024

Profession
Osteopathic Physician
License
OS15092
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
3/31/2026
License Original Issue Date
01/30/2018
Address of Record
430 Morton Plant St
Ste 301
CLEARWATER, FL 33756
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
8839 Bryan Dairy Rd Ste 240
LARGO, FL 33777
Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
COMMENT, CLAIRE Prescribing Physician Assistant Physician Assistant 9115578 7/26/2023
GOURLEY, CYNTHIA YOUNG Prescribing Physician Assistant Physician Assistant 9101235 7/26/2023
MCMICHAEL, CHRISTOPHER SCOTT Prescribing Physician Assistant Physician Assistant 9105882 5/18/2023
SMITH, CHRISTOPHER ROBERT Prescribing Physician Assistant Physician Assistant 9107940 7/26/2023

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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 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.