License Verification

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DIANE CAROLE HATCH

License Number: PA3214

Data As Of 12/23/2024

Profession
Physician Assistant
License
PA3214
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
12/20/1996
Address of Record
2777 ENTERPRISE ROAD
ORANGE CITY, FL 32763
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
350 N. Clyde Morris Blvd.
DAYTONA BEACH, FL 32114
Address
201 N. Clyde Morris Blvd.
DAYTONA BEACH, FL 32114
Address
309 & 315 Palm Coast Parkway
PALM COAST, FL 32137
Address
937 N. Spring Gardens Ave.
DELAND, FL 32720
Address
461 S. Nova Rd.
ORMOND BEACH, FL 32174
Address
1182 Ocean Shore Blvd.
ORMOND BEACH, FL 32176
Address
1184 OCEAN SHORE BLVD.
ORMOND BEACH, FL 32176
Address
239 N. Ridgewood Ave
EDGEWATER, FL 32132
Address
740 Dunlawton Ave
PORT ORANGE, FL 32127
Address
1340 Ridgewood Ave
DAYTONA BEACH, FL 32117
Address
320 N. Clyde Morris Blvd.
DAYTONA BEACH, FL 32114
Address
707 Platinum Point
LAKE MARY, FL 32746
Address
4106 West Lake Mary Blvd Ste 225
LAKE MARY, FL 32746
Name Relationship Profession License Effective Date
BLY, KRIS MARIE Supervising Prescribing Practitioner Osteopathic Physician 10451 03/26/2021
GRIGG, JOHNSIE CAROL Supervising Prescribing Practitioner Medical Doctor 47294 02/05/2019
LE, ELIZABETH ANN Supervising Prescribing Practitioner Medical Doctor 99663 02/05/2019
MCCARTHY, GREGORY EDWARD Supervising Prescribing Practitioner Medical Doctor 121306 12/28/2018
NIPPER, NEIL BAKER MD Supervising Prescribing Practitioner Medical Doctor 108608 02/01/2016

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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.