License Verification

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BROOKE DYAN TOLLAND

License Number: PA9105485

Data As Of 12/24/2024

Profession
Physician Assistant
License
PA9105485
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
06/22/2010
Address of Record
1075 Mason Ave
DAYTONA BEACH, FL 32117
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1890 LPGA Blvd Suite 240
DAYTONA BEACH, FL 32117
Address
17 Old Kings Road N Suite K
PALM COAST, FL 32137
Address
1165 Dunlawton Ave Suite 102
PORT ORANGE, FL 32127
Address
1175 Dunlawton Ave Suite 1
PORT ORANGE, FL 32127
Address
1865 LPGA Blvd
DAYTONA BEACH, FL 32117
Name Relationship Profession License Effective Date
GILLESPY, ALBERT WILLIAM Supervising Dispensing Practitioner Medical Doctor 50714 01/17/2024

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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 12/24/2024



* 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.