License Verification

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GLENN JOSEPH LYSACK

License Number: PA3242

Data As Of 12/23/2024

Profession
Physician Assistant
License
PA3242
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
01/02/1997
Address of Record
280 Washington Ave
Unit 504
Bremerton
BREMERTON, WA 98337
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
Yes - Click on Discipline/Admin Action tab to see more details
Public Complaint
Yes - Click on Discipline/Admin Action tab to see more details

No secondary locations found.


Name Relationship Profession License Effective Date
COSTELLO, TIMOTHY DAVID Supervising Prescribing Practitioner Medical Doctor 137708 07/22/2020
HARRIS, JAMES WILSON V Supervising Prescribing Practitioner Medical Doctor 103744 10/22/2018
HILL, JOHN PATRICK Supervising Prescribing Practitioner Medical Doctor 126139 04/13/2016
HUGHES, RICHARD JAMES Supervising Prescribing Practitioner Medical Doctor 69446 10/22/2018
LEE, ROENTGEN KWAN-REN Supervising Prescribing Practitioner Osteopathic Physician 9327 10/22/2018
LUECK, CAMERON HANFORD MD Supervising Prescribing Practitioner Medical Doctor 78993 03/14/2016
MCALLISTER, PAMELA LEE Supervising Prescribing Practitioner Osteopathic Physician 11428 10/22/2018
NASCA, LEONARDO SALVATORE JR Supervising Prescribing Practitioner Medical Doctor 45313 09/13/2019
SCHOTT, ERIC Supervising Prescribing Practitioner Medical Doctor 133946 04/05/2018
SCOTT, JACK DOUGLAS MD Supervising Prescribing Practitioner Medical Doctor 69637 09/13/2019

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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.


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