License Verification

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THOMAS JOHN HINES

License Number: PA9105044

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9105044
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
06/24/2009
Address of Record
45 W. Crystal Lake Street
Suite 197
ORLANDO, FL 32806
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
2911 Red Bug Lake Road
CASSELBERRY, FL 32707
Name Relationship Profession License Effective Date
DOWNING, JEFFREY ADAM Supervising Dispensing Practitioner Osteopathic Physician 7708 07/15/2022
DOWNING, JEFFREY ADAM Supervising Prescribing Practitioner Osteopathic Physician 7708 07/15/2022
MCCLEARY, MICHAEL DOUGLAS Supervising Dispensing Practitioner Medical Doctor 98424 11/04/2019
MCCLEARY, MICHAEL DOUGLAS Supervising Prescribing Practitioner Medical Doctor 98424 11/04/2019
PHIPPS, THOMAS ANDREW MD Supervising Dispensing Practitioner Medical Doctor 123899 12/09/2016
PHIPPS, THOMAS ANDREW MD Supervising Prescribing Practitioner Medical Doctor 123899 10/10/2016

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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 12/23/2024



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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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