License Verification

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THOM RICHARD SHIMANDLE

License Number: PA9101577

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9101577
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
03/13/2001
Address of Record
206 2ND STREET EAST
MANATEE MEMORIAL HOSPITAL
BRADENTON, FL 34208
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
8330 LAKEWOOD RANCH BLVD. LAKEWOOD RANCH MEDICAL CENTER
LAKEWOOD RANCH, FL 34202
Name Relationship Profession License Effective Date
ALVAREZ, JOHNNY D Supervising Prescribing Practitioner Medical Doctor 50611 10/30/2017
BROWN, JAN II Supervising Prescribing Practitioner Medical Doctor 113488 09/20/2018
CHRISTENSEN, DEAN ALLAN Supervising Prescribing Practitioner Medical Doctor 32644 09/20/2018
DEMINO, TRACEY IAN Supervising Prescribing Practitioner Medical Doctor 94690 10/30/2017
HAGGARTY, JOHN BRUCE Supervising Prescribing Practitioner Medical Doctor 101635 10/30/2017
HALL, MITCHELL FREDERICK Supervising Prescribing Practitioner Medical Doctor 80540 10/30/2017
HENRY, MICHAEL D O Supervising Prescribing Practitioner Osteopathic Physician 8911 10/30/2017
HIERHOLZER, DANNY MICHAEL DO Supervising Prescribing Practitioner Osteopathic Physician 11234 09/20/2018
HIERHOLZER, MELINDA BETH Supervising Prescribing Practitioner Osteopathic Physician 11250 10/30/2017
JOLLY, MARK ESTON MD Supervising Prescribing Practitioner Medical Doctor 100262 10/30/2017
KOLLA, JAYA KRISHNA Supervising Prescribing Practitioner Medical Doctor 118422 10/30/2017
LEROY, ADAM DAVID Supervising Prescribing Practitioner Medical Doctor 103353 09/20/2018
MACHER, AMY NICHOLE DR Supervising Prescribing Practitioner Medical Doctor 119919 10/30/2017
MCLANE, RAYMOND E M D Supervising Prescribing Practitioner Medical Doctor 12381 01/23/2019
MERCURY, DYLAN Supervising Dispensing Practitioner Osteopathic Physician 15380 12/12/2018
MERCURY, DYLAN Supervising Prescribing Practitioner Osteopathic Physician 15380 12/12/2018
PFEIFFER, ROBERT FULTON Supervising Prescribing Practitioner Medical Doctor 93862 12/28/2018
RATCLIFFE, DAVID NELSON Supervising Prescribing Practitioner Osteopathic Physician 6903 10/30/2017
RAWE, TERESA RENEE Supervising Prescribing Practitioner Osteopathic Physician 5702 10/30/2017
REPASKEY, DEBORAH MARIE LUIKEN MD Supervising Prescribing Practitioner Medical Doctor 113108 10/30/2017
RILEY, VICTORIA LYNN Supervising Prescribing Practitioner Medical Doctor 89026 10/30/2017
SCOTT, SHEKYLA N Supervising Prescribing Practitioner Medical Doctor 105197 10/30/2017
SHAH, NISHAN ANIL Supervising Prescribing Practitioner Medical Doctor 123001 10/30/2017
SPONAUGLE, JOHN WAYNE Supervising Prescribing Practitioner Osteopathic Physician 6336 03/06/2019
TANA, CHRISTOPHER FRANK Supervising Prescribing Practitioner Osteopathic Physician 10435 09/20/2018
WHITE, HEBRON BANCROFT Supervising Prescribing Practitioner Medical Doctor 111009 10/30/2017
ZIKA, BLAKE A Supervising Prescribing Practitioner Osteopathic Physician 9230 10/30/2017

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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.


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.