License Verification

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Polk County Board of County Commissioners

License Number: ALS5302

Data As Of 12/22/2024

Profession
EMS Service Provider (ALS)
License
ALS5302
License Status
CLEAR/
Qualifications
Transport
License Expiration Date
6/15/2025
License Original Issue Date
06/16/1993
Address of Record
1295 Brice Boulevard
BARTOW, FL 33830
Discipline on File
No
Address
1140 North Galloway Road
LAKELAND, FL 33810
Address
901 Ledwith Avenue
HAINES CITY, FL 33844
Address
1105 Highway 98 West
FROSTPROOF, FL 33843
Address
229 Avenue D Northwest
WINTER HAVEN, FL 33881
Address
3325 East Main Street
LAKELAND, FL 33801
Address
310 3rd Street
AUBURNDALE, FL 33823
Address
333 American Spirit Road
WINTER HAVEN, FL 33880
Address
8936 Highway 98 North
LAKELAND, FL 33809
Address
1201 Cypress Parkway
POINCIANA, FL 34759
Address
300 North Seminole Avenue
LAKE ALFRED, FL 33850
Address
14684 Highway 27
LAKE WALES, FL 33853
Address
1255 East Lime Street
LAKELAND, FL 33801
Address
3205 Winter Lake Road
LAKELAND, FL 33803
Address
6221 Hogan Lane
INDIAN LAKE ESTATES, FL 33855
Address
4101 Clubhouse Road
HIGHLAND CITY, FL 33846
Address
1800 West Parker Street
LAKELAND, FL 33815
Address
6525 Ronald Reagan Parkway
DAVENPORT, FL 33896
Address
2041 Thompson Nursery Road
LAKE WALES, FL 33859
Address
118 Merrill Avenue
DUNDEE, FL 33838
Address
9500 Marigold Avenue
KISSIMMEE, FL 34759
Address
1235 9th Street Northeast
FORT MEADE, FL 33841
Address
510 Ronald Reagan Parkway
LOUGHMAN, FL 33858
Address
2902 Highway 60 East
LAKE WALES, FL 33853
Address
200 Commonwealth Boulevard Southwe
POLK CITY, FL 33868
Address
126 Cottonwood Drive
DAVENPORT, FL 33837
Address
50945 U.S. Highway 27
DAVENPORT, FL 33837
Address
69101 Nalcrest Road
NALCREST, FL 33856
Address
3822 South Florida Avenue
LAKELAND, FL 33813
Address
4210 Willis Road
MULBERRY, FL 33860
Address
7800 Watkins Road
HAINES CITY, FL 33844
Address
5361 Rifle Range Road
BARTOW, FL 33830
Address
5201 Cornell Street
LAKELAND, FL 33810
Address
2523 Ewell Road
LAKELAND, FL 33813
Address
714 North Scenic Highway
BABSON PARK, FL 33827
Address
6949 Old Highway 37
BRADLEY, FL 33835
Address
2475 Clower Lane
BARTOW, FL 33830
Address
75 Broad Way
LAKE HAMILTON, FL 33851
Address
2101 Register Road Southeast
WINTER HAVEN, FL 33884
Address
185 South 3rd Street
EAGLE LAKE, FL 33839
Address
2029 Florida Highway 60
LAKE WALES, FL 33859
Address
3595 Kokomo Road
HAINES CITY, FL 33844
Address
112 Palmetto Street West
DAVENPORT, FL 33837
Address
1385 Fort Mead Road
FROSTPROOF, FL 33843
Address
300 Kid Ellis Road
MULBERRY, FL 33860
Address
6750 Kathleen Road
LAKELAND, FL 33809
Name Relationship Profession License Effective Date
BANERJEE, PUSHPAL R Primiary Medical Director Osteopathic Physician 8141 02/11/2014
SOBOWALE, OLUMIDE OLUFUNMI Secondary Medical Director Medical Doctor 63869 10/01/2012

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date
1F93544214H140232 Permit Vehicle Permit (ALS) 20609 4/20/2017
1F93544224H140207 Permit Vehicle Permit (ALS) 16195 8/30/2010
1F93544255H140315 Permit Vehicle Permit (ALS) 19301 8/3/2015
1F93544255H140316 Permit Vehicle Permit (ALS) 13624 3/15/2006
1F93544296H140403 Permit Vehicle Permit (ALS) 20755 7/5/2017
1F94044217H140464 Permit Vehicle Permit (ALS) 17155 3/30/2012
1F94044228H140555 Permit Vehicle Permit (ALS) 20375 1/9/2017
1F94054208H140561 Permit Vehicle Permit (ALS) 25891 3/21/2024
1F94054228H140562 Permit Vehicle Permit (ALS) 22709 1/13/2020
1FACWFC2KHKG4096 Permit Vehicle Permit (ALS) 21708 8/16/2018
1FD0W5HT8GEC45891 Permit Vehicle Permit (ALS) 20164 10/31/2016
1FD0X5GT8BEC30864 Permit Vehicle Permit (ALS) 22294 7/3/2019
1FD0X5GT8LEC32650 Permit Vehicle Permit (ALS) 22840 3/3/2020
1FD0X5GTXLEC32651 Permit Vehicle Permit (ALS) 22841 3/3/2020
1FD0X5GY0GEB79184 Permit Vehicle Permit (ALS) 20124 10/13/2016
1FD0X5GY9FEA13339 Permit Vehicle Permit (ALS) 18654 10/1/2014
1FDOX5GY4DEA42261 Permit Vehicle Permit (ALS) 18043 8/20/2013
1FDWE3FS0JDC16619 Permit Vehicle Permit (ALS) 21355 3/26/2018
1FDWE3FS9JDC14836 Permit Vehicle Permit (ALS) 21354 3/26/2018
1FMCU0F79JUB20407 Permit Vehicle Permit (ALS) 26359 9/10/2024
1FMCUOF74JUA27942 Permit Vehicle Permit (ALS) 26356 9/10/2024
1FMSK7BH0RGA25611 Permit Vehicle Permit (ALS) 26357 9/10/2024
1FMSK7BH6RGA25497 Permit Vehicle Permit (ALS) 26355 9/10/2024
1FMSK7BH8RGA25503 Permit Vehicle Permit (ALS) 26358 9/10/2024
1FT7W2A65NEG16816 Permit Vehicle Permit (ALS) 24968 3/6/2023
1FT7W2A68NEC15826 Permit Vehicle Permit (ALS) 24076 11/10/2021
1FT7W2AA1PEC35746 Permit Vehicle Permit (ALS) 25522 10/11/2023
1FT7W2AA1REC42229 Permit Vehicle Permit (ALS) 26047 5/23/2024
1FT7X2BT2EEB80525 Permit Vehicle Permit (ALS) 18471 7/10/2014
1FTFW1P88NKD26599 Permit Vehicle Permit (ALS) 25266 8/15/2023
1FVACWDT0BDAV9765 Permit Vehicle Permit (ALS) 17925 5/28/2013
1FVACWDT0EHFV1404 Permit Vehicle Permit (ALS) 22981 5/11/2020
1FVACWDT0FHGK0500 Permit Vehicle Permit (ALS) 18853 2/11/2015
1FVACWDT0GHHF9295 Permit Vehicle Permit (ALS) 19990 7/6/2016
1FVACWDT1BDAZ1480 Permit Vehicle Permit (ALS) 16440 1/28/2011
1FVACWDT1GHHK828 Permit Vehicle Permit (ALS) 20504 3/8/2017
1FVACWDT2FHGK0501 Permit Vehicle Permit (ALS) 19002 4/6/2015
1FVACWDT2HHJD8090 Permit Vehicle Permit (ALS) 20566 4/12/2017
1FVACWDT38DAZ1481 Permit Vehicle Permit (ALS) 22980 5/11/2020
1FVACWDT3BDAZ1478 Permit Vehicle Permit (ALS) 16438 1/28/2011
1FVACWDT4FHGK0502 Permit Vehicle Permit (ALS) 19003 4/6/2015
1FVACWDT4GHHK8281 Permit Vehicle Permit (ALS) 19798 3/14/2016
1FVACWDT6FHGK0503 Permit Vehicle Permit (ALS) 19004 4/6/2015
1FVACWDT6GHHC9721 Permit Vehicle Permit (ALS) 19645 12/7/2015
1FVACWDT6GHHK8282 Permit Vehicle Permit (ALS) 19949 6/14/2016
1FVACWDT6HHJD8089 Permit Vehicle Permit (ALS) 20565 4/12/2017
1FVACWDT7BDAV9763 Permit Vehicle Permit (ALS) 17923 5/28/2013
1FVACWDT7EHFV1402 Permit Vehicle Permit (ALS) 18388 5/29/2014
1FVACWDT8FHGK0498 Permit Vehicle Permit (ALS) 18798 1/13/2015
1FVACWDT8FHGK0499 Permit Vehicle Permit (ALS) 18799 1/13/2015
1FVACWDT8GHH43683 Permit Vehicle Permit (ALS) 19948 6/14/2016
1FVACWDT8GHHC9722 Permit Vehicle Permit (ALS) 19566 10/26/2015
1FVACWDT8GHHK8283 Permit Vehicle Permit (ALS) 20422 2/14/2017
1FVACWDT9BDAV9764 Permit Vehicle Permit (ALS) 22280 7/3/2019
1FVACWDT9EHFV1403 Permit Vehicle Permit (ALS) 18387 5/29/2014
1FVACWDT9GHHF9294 Permit Vehicle Permit (ALS) 19989 7/6/2016
1FVACWDTXGHHC9723 Permit Vehicle Permit (ALS) 19565 10/26/2015
1FVACWDTXGHHK8284 Permit Vehicle Permit (ALS) 20608 4/20/2017
1FVACWFC0MHMP5935 Permit Vehicle Permit (ALS) 23615 4/5/2021
1FVACWFC1JHJT2739 Permit Vehicle Permit (ALS) 21159 12/12/2017
1FVACWFC1NHNC0586 Permit Vehicle Permit (ALS) 24166 1/25/2022
1FVACWFC1NHNC0586 Permit Vehicle Permit (ALS) 25167 7/10/2023
1FVACWFC2MHMP5936 Permit Vehicle Permit (ALS) 23616 4/5/2021
1FVACWFC3MHMP5931 Permit Vehicle Permit (ALS) 23611 4/5/2021
1FVACWFC3NHNC0587 Permit Vehicle Permit (ALS) 24358 6/2/2022
1FVACWFC3NHNC0590 Permit Vehicle Permit (ALS) 24361 6/2/2022
1FVACWFC4MHMP5937 Permit Vehicle Permit (ALS) 23617 4/5/2021
1FVACWFC5MHMP5932 Permit Vehicle Permit (ALS) 23612 4/5/2021
1FVACWFC5NHNC0588 Permit Vehicle Permit (ALS) 24359 6/2/2022
1FVACWFC5NHNC0591 Permit Vehicle Permit (ALS) 24496 8/29/2022
1FVACWFC6JHJT2736 Permit Vehicle Permit (ALS) 21156 12/12/2017
1FVACWFC6KHKR3878 Permit Vehicle Permit (ALS) 22281 7/3/2019
1FVACWFC7MHMP5933 Permit Vehicle Permit (ALS) 23613 4/5/2021
1FVACWFC7NHNC0589 Permit Vehicle Permit (ALS) 24360 6/2/2022
1FVACWFC8JHJT2737 Permit Vehicle Permit (ALS) 21157 12/12/2017
1FVACWFC8JHJT2740 Permit Vehicle Permit (ALS) 21160 12/12/2017
1FVACWFC8KHKR3879 Permit Vehicle Permit (ALS) 22282 7/3/2019
1FVACWFC8KHKR3882 Permit Vehicle Permit (ALS) 22292 7/3/2019
1FVACWFC9MHMP5934 Permit Vehicle Permit (ALS) 23614 4/5/2021
1FVACWFCXJHJT2738 Permit Vehicle Permit (ALS) 21158 12/12/2017
1FVACWFCXKHKR3883 Permit Vehicle Permit (ALS) 22293 7/3/2019
1FVACWFCXNHNC0585 Permit Vehicle Permit (ALS) 24165 1/25/2022
1GC1CUEG5HF116697 Permit Vehicle Permit (ALS) 20737 6/21/2017
1GC1CUEG7JF170220 Permit Vehicle Permit (ALS) 21377 4/9/2018
1S9A1HD6G1003055 Permit Vehicle Permit (ALS) 22475 9/12/2019
1S9A1HND2N1003051 Permit Vehicle Permit (ALS) 24420 7/11/2022
1S9A1HND8G1003056 Permit Vehicle Permit (ALS) 19950 6/14/2016
1S9A7LLE952003040 Permit Vehicle Permit (ALS) 18374 5/15/2014
2FZACFDT7AAAN3339 Permit Vehicle Permit (ALS) 15523 5/19/2009
2GC2KREG7K1162308 Permit Vehicle Permit (ALS) 22177 4/25/2019
2GC2KREG8K1818 Permit Vehicle Permit (ALS) 22115 3/19/2019
3ALACEFC9KDKS9466 Permit Vehicle Permit (ALS) 22283 7/3/2019
3ALACWFC0JDJW5723 Permit Vehicle Permit (ALS) 21161 12/12/2017
3ALACWFC1JDJW5729 Permit Vehicle Permit (ALS) 21167 12/12/2017
3ALACWFC1KDKS9446 Permit Vehicle Permit (ALS) 22285 7/3/2019
3ALACWFC2JDJW5724 Permit Vehicle Permit (ALS) 21162 12/12/2017
3ALACWFC2RDUX4440 Permit Vehicle Permit (ALS) 26039 5/22/2024
3ALACWFC2RDUX4441 Permit Vehicle Permit (ALS) 26040 5/22/2024
3ALACWFC2RDUX4442 Permit Vehicle Permit (ALS) 26041 5/22/2024
3ALACWFC2RDUX4443 Permit Vehicle Permit (ALS) 26042 5/22/2024
3ALACWFC2RDUX4444 Permit Vehicle Permit (ALS) 26035 5/22/2024
3ALACWFC2RDUX4445 Permit Vehicle Permit (ALS) 26036 5/22/2024
3ALACWFC2RDUX4446 Permit Vehicle Permit (ALS) 26037 5/22/2024
3ALACWFC2RDUX4447 Permit Vehicle Permit (ALS) 26038 5/22/2024
3ALACWFC3KDKS9447 Permit Vehicle Permit (ALS) 22286 7/3/2019
3ALACWFC3KDKS9450 Permit Vehicle Permit (ALS) 22289 7/3/2019
3ALACWFC3PDNU5583 Permit Vehicle Permit (ALS) 25017 4/12/2023
3ALACWFC4JDJW5725 Permit Vehicle Permit (ALS) 21163 12/12/2017
3ALACWFC5KDKS9448 Permit Vehicle Permit (ALS) 22287 7/3/2019
3ALACWFC5KDKS9451 Permit Vehicle Permit (ALS) 22290 7/3/2019
3ALACWFC5PDNU5584 Permit Vehicle Permit (ALS) 25018 4/12/2023
3ALACWFC6JDJW5726 Permit Vehicle Permit (ALS) 21164 12/12/2017
3ALACWFC7KDKS9449 Permit Vehicle Permit (ALS) 22288 7/3/2019
3ALACWFC7KDKS9452 Permit Vehicle Permit (ALS) 22291 7/3/2019
3ALACWFC8JDJW5727 Permit Vehicle Permit (ALS) 21165 12/12/2017
3ALACWFC9KDKS9467 Permit Vehicle Permit (ALS) 22284 7/3/2019
3ALACWFCXJDJW5728 Permit Vehicle Permit (ALS) 21166 12/12/2017
44KFT42858WZ21192 Permit Vehicle Permit (ALS) 15481 4/21/2009
44KTF4283AWZ21908 Permit Vehicle Permit (ALS) 17156 3/30/2012
4EN6AAA80J1001677 Permit Vehicle Permit (ALS) 22041 2/7/2019
4EN6AAA81J1001400 Permit Vehicle Permit (ALS) 21990 1/10/2019
4EN6AAA81K1002029 Permit Vehicle Permit (ALS) 22443 8/22/2019
4EN6AAA81L1002744 Permit Vehicle Permit (ALS) 22979 5/11/2020
4EN6AAA85J1001402 Permit Vehicle Permit (ALS) 23124 8/17/2020
4EN6AAA88L1002742 Permit Vehicle Permit (ALS) 22977 5/11/2020
4EN6AAA89J1001399 Permit Vehicle Permit (ALS) 21989 1/10/2019
4EN6AAA89J1001676 Permit Vehicle Permit (ALS) 21993 1/10/2019
4EN6AAA8XL1002743 Permit Vehicle Permit (ALS) 22978 5/11/2020
4EN8AAA83J1001401 Permit Vehicle Permit (ALS) 21991 1/10/2019
4ENRAAA8661001381 Permit Vehicle Permit (ALS) 14690 1/4/2008
4ENRAAA8951000031 Permit Vehicle Permit (ALS) 13777 7/19/2006
4P1BAAFF2GA015943 Permit Vehicle Permit (ALS) 25887 3/21/2024
4P1BAAFF4GA015944 Permit Vehicle Permit (ALS) 19700 1/20/2016
4P1BAAFF4NA025077 Permit Vehicle Permit (ALS) 25016 4/12/2023
4P1BAAFF4NA025078 Permit Vehicle Permit (ALS) 25015 4/12/2023
4P1BAAFF5NA024620 Permit Vehicle Permit (ALS) 25860 3/7/2024
4P1BAAFF7MA023404 Permit Vehicle Permit (ALS) 24121 12/8/2021
4P1BAAFF9MA023405 Permit Vehicle Permit (ALS) 24122 12/8/2021
4P1BAAFF9RA027185 Permit Vehicle Permit (ALS) 26419 10/10/2024
4P1BAAGF2GA016394 Permit Vehicle Permit (ALS) 20376 1/9/2017
4P1BAAGF4GA015795 Permit Vehicle Permit (ALS) 19567 10/28/2015
4P1BAAGF4GA016395 Permit Vehicle Permit (ALS) 20653 5/8/2017
4P1BAAGF5JA018132 Permit Vehicle Permit (ALS) 20965 10/5/2017
4P1BAAGF6GA015796 Permit Vehicle Permit (ALS) 19568 10/28/2015
4P1BAAGF6KA020585 Permit Vehicle Permit (ALS) 22311 7/10/2019
4P1BAAGF7RA026891 Permit Vehicle Permit (ALS) 26418 10/10/2024
4P1BAAGF8MA023295 Permit Vehicle Permit (ALS) 24262 3/28/2022
4P1BAAGF9RA026892 Permit Vehicle Permit (ALS) 26417 10/10/2024
4P1BBAGF5FA015297 Permit Vehicle Permit (ALS) 18852 2/12/2015
4P1BCAFF0PA025932 Permit Vehicle Permit (ALS) 25859 3/7/2024
4P1BCAFF1NA024950 Permit Vehicle Permit (ALS) 25014 4/12/2023
4P1BCAFF1RA026607 Permit Vehicle Permit (ALS) 26178 8/6/2024
4P1BCAFF3RA026611 Permit Vehicle Permit (ALS) 26179 8/6/2024
4P1BCAGFFXPA025256 Permit Vehicle Permit (ALS) 25168 7/10/2023
4P1CU01E29A009566 Permit Vehicle Permit (ALS) 15482 4/23/2009
4P1CU01E76A006500 Permit Vehicle Permit (ALS) 16407 1/18/2011
4P1CU01E7AA010863 Permit Vehicle Permit (ALS) 16133 7/16/2010
4P1CU01E8BA011473 Permit Vehicle Permit (ALS) 16409 1/18/2011
4P1CU01EX5A005632 Permit Vehicle Permit (ALS) 20163 10/31/2016
4P1CU01N3DA013635 Permit Vehicle Permit (ALS) 17824 3/13/2013
4P1CV01A0CA012841 Permit Vehicle Permit (ALS) 20374 1/9/2017
4P1CV01AXBA012134 Permit Vehicle Permit (ALS) 17010 12/5/2011
4P1CV01D1DA013878 Permit Vehicle Permit (ALS) 18118 9/30/2013
4P1CV01D1EA013915 Permit Vehicle Permit (ALS) 25135 6/15/2023
4P1CV01D3DA013865 Permit Vehicle Permit (ALS) 24120 12/8/2021
4P1CV01D5DA013866 Permit Vehicle Permit (ALS) 21378 4/9/2018
4P1CV01D7DA013867 Permit Vehicle Permit (ALS) 25134 6/15/2023
4P1CV0D9DA013868 Permit Vehicle Permit (ALS) 23410 1/11/2021
4S7HT23912C040149 Permit Vehicle Permit (ALS) 14689 1/4/2008
4S7HT2393YC034460 Permit Vehicle Permit (ALS) 14390 6/14/2007
4S7HT2B937CO57169 Permit Vehicle Permit (ALS) 14345 5/21/2007
4S7HT2B987CO58253 Permit Vehicle Permit (ALS) 17463 9/11/2012
4S7HT2B9X7C058254 Permit Vehicle Permit (ALS) 17577 11/20/2012
4UZABRDJ49CAE1887 Permit Vehicle Permit (ALS) 25622 11/20/2023

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner



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.


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.