License Verification

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JERRI JOANN KRUEP

License Number: PA9103531

Data As Of 10/5/2024

Profession
Physician Assistant
License
PA9103531
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
10/11/2005
Address of Record
16202 Muirfield Dr
ODESSA, FL 33556
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
DIAMOND, HOWARD MD Supervising Prescribing Practitioner Medical Doctor 58424 04/30/2020
LUU, CUONG CHI Supervising Prescribing Practitioner Medical Doctor 92624 08/12/2016
TOMELDEN, CORNELIO Supervising Dispensing Practitioner Medical Doctor 91028 11/02/2016

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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 10/5/2024



* 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.