License Verification

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LEE-DYLAN M LOCKE

License Number: PA9113914

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9113914
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
12/17/2020
Address of Record
5221 Clark Rd
SARASOTA, FL 34233
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
2830 Bee Ridge Road
SARASOTA, FL 34239
Address
3018 53rd Avenue East Prime Health
BRADEN RIVER, FL 34203
Address
5221 Clark Road Prime Health
SARASOTA, FL 34233
Name Relationship Profession License Effective Date
ARISTIMUNO, JOAQUIN J Supervising Prescribing Practitioner Medical Doctor 66311 03/03/2022
ESPINEL, ALFONSO LUIS Supervising Dispensing Practitioner Medical Doctor 114272 10/11/2022
TOBIAS, GLENN THOMAS Supervising Dispensing Practitioner Osteopathic Physician 6200 08/26/2022
TOBIAS, GLENN THOMAS Supervising Prescribing Practitioner Osteopathic Physician 6200 07/16/2021

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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.