License Verification

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JENNIFER LYNN VAN KEULEN

License Number: PA9115519

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9115519
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
01/14/2022
Address of Record
303 W Palm Ave
TAMPA, FL 33602
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
19027 Wingshooter Way
LUTZ, FL 33558
Address
22945 State Road 54
LUTZ, FL 33549
Address
2810 W M.L.K. Jr Blvd
TAMPA, FL 33607
Address
13856 N Dale Mabry Hwy
TAMPA, FL 33618
Address
4949 4th Street North
SAINT PETERSBURG, FL 33703
Address
13531 State Rd. 54
ODESSA, FL 33556
Address
3301 W Gandy Blvd
TAMPA, FL 33611
Address
5504 Gateway Blvd
WESLEY CHAPEL, FL 33544
Address
11969 Sheldon Road
TAMPA, FL 33626
Address
4505 Gunn Highway
TAMPA, FL 33624
Address
11406 US Hwy 301 S
RIVERVIEW, FL 33578
Address
7601 Seminole Blvd
SEMINOLE, FL 33772
Address
3251 66th St North
SAINT PETERSBURG, FL 33710
Address
799 W Lumsden Rd
BRANDON, FL 33511
Address
16521 US Hwy 301 S
WIMAUMA, FL 33598
Address
564 Channelside Dr
TAMPA, FL 33602
Address
5464 Lithia Pinecrest Drive
LITHIA, FL 33547
Address
40545 US Hwy 19N Unit A
TARPON SPRINGS, FL 34689
Address
6182 N US Highway 41
APOLLO BEACH, FL 33572
Name Relationship Profession License Effective Date
NANDA, PAUL KALRA Supervising Dispensing Practitioner Medical Doctor 117861 10/13/2023

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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 12/22/2024



* 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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