License Verification

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MARTIN ROBERT BACK

License Number: ME71212

Data As Of 4/28/2025

Profession
Medical Doctor
License
ME71212
License Status
CLEAR/Active
License Expiration Date
1/31/2027
License Original Issue Date
08/09/1996
Address of Record
1329 SW 16th St, room 3120
UF Division of Vascular Surgery
GAINESVILLE, FL 32610
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
CARROLL, LEAH MARIE Prescribing Physician Assistant Physician Assistant 9111743 10/12/2020
CEBREROS, MICHAEL JOSEPH Prescribing Physician Assistant Physician Assistant 9115332 2/7/2022
JEANTY, MAX DONALD Prescribing Physician Assistant Physician Assistant 9117853 1/28/2025
LARRANAGA, VICTORIA Prescribing Physician Assistant Physician Assistant 9119399 1/14/2025
ROSEN, SARA Prescribing Physician Assistant Physician Assistant 9111912 9/17/2020
SALAMEH, BESAN Prescribing Physician Assistant Physician Assistant 9115841 9/20/2022
SHIFFLET, JENNIFER NICOLE Prescribing Physician Assistant Physician Assistant 9112494 12/6/2019
STALEY, MONICA Prescribing Physician Assistant Physician Assistant 9116076 9/20/2022

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 4/29/2025



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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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