License Verification

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REBECCA KAITLIN DOUGLAS

License Number: PA9116143

Data As Of 4/19/2025

Profession
Physician Assistant
License
PA9116143
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
07/05/2022
Address of Record
2615 N. Monroe Street
Suite #1
TALLAHASSEE, FL 32303
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
1730 Pat Thomas Parkway
QUINCY, FL 32351-8681
Address
542435 US Highway 1
CALLAHAN, FL 32011
Address
19545 S State Road 228
MACCLENNY, FL 32063
Address
16314 Northwest US Highway 441
ALACHUA, FL 32615
Address
2261 Northwest 43rd Street
GAINESVILLE, FL 32605
Address
14044 SE 48th Avenue
STARKE, FL 32091
Address
5861 Dogwood Drive
MILTON, FL 32570
Address
1702 Ohio Ave. N
LIVE OAK, FL 32064
Name Relationship Profession License Effective Date
LEE, MATTHEW CHRISTOPHER Supervising Dispensing Practitioner Medical Doctor 112458 05/20/2024
LEE, MATTHEW CHRISTOPHER Supervising Prescribing Practitioner Medical Doctor 112458 08/01/2022
PARK, THOMAS MATTHEW Supervising Dispensing Practitioner Medical Doctor 85708 05/23/2024
PARK, THOMAS MATTHEW Supervising Prescribing Practitioner Medical Doctor 85708 08/02/2022

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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 4/20/2025



* 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.