License Verification

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MICHAEL LENOX SULLIVAN

License Number: PA3485

Data As Of 12/23/2024

Profession
Physician Assistant
License
PA3485
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
01/02/1998
Address of Record
1540 S. TAMIAMI TRAIL
SUITE 303
SARASOTA, FL 34239
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1700 S. Tamiami Trail Sarasota Memorial Hospital
SARASOTA, FL 34239
Name Relationship Profession License Effective Date
AGARWAL, SAMIR Supervising Prescribing Practitioner Medical Doctor 145876 02/21/2022
BRICENO, PEDRO JOSE Supervising Prescribing Practitioner Medical Doctor 105330 02/21/2022
FONG, JONATHAN CHRISTOPHER M D Supervising Prescribing Practitioner Medical Doctor 80268 11/15/2023
HOFFBERGER, JONATHAN DAVID Supervising Prescribing Practitioner Osteopathic Physician 10986 11/15/2023
MARSHALL, MARGARET BLAIR Supervising Prescribing Practitioner Medical Doctor 163715 12/18/2023
SELL, JEFFREY EDWARD Supervising Prescribing Practitioner Medical Doctor 114933 12/18/2023
VESCO, PAUL ANTHONY Supervising Prescribing Practitioner Medical Doctor 108379 11/15/2023
WALKER, KRISTEN LEIGH Supervising Prescribing Practitioner Medical Doctor 144948 11/15/2023

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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 12/23/2024



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** 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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