License Verification

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JIMMIE CONRAD CRAWFORD

License Number: PA9104289

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9104289
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
08/20/2007
Address of Record
1009 Creighton Road
Titan Wellness of Fl. LLC
PENSACOLA, FL 32504
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
ALSHAZLEY, MOUDAR Supervising Prescribing Practitioner Medical Doctor 78728 09/23/2016
CARLSON, WILLIAM SHAW Supervising Prescribing Practitioner Medical Doctor 121446 09/23/2016
KALAJI, ZAHER Supervising Prescribing Practitioner Medical Doctor 73792 09/23/2016
KELLER, ALEXANDER PAUL IV Supervising Prescribing Practitioner Medical Doctor 118952 09/23/2016
NODINE, STEVEN LEE Supervising Prescribing Practitioner Osteopathic Physician 11996 10/28/2016
NOGGLE, TOMMY STEVEN MD Supervising Prescribing Practitioner Medical Doctor 93880 09/23/2016
ORBEZO, ANED M Supervising Prescribing Practitioner Medical Doctor 95479 09/23/2016
PATEL, JAIMIN BALWANT M D Supervising Prescribing Practitioner Medical Doctor 104797 10/28/2016
PHELPS, ANID ORBEZO Supervising Prescribing Practitioner Medical Doctor 94653 11/10/2016
SINGLEY, CHRISTOPHER LEE Supervising Prescribing Practitioner Medical Doctor 101636 09/23/2016

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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 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.