License Verification

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ELIZABETH MARGARET ENNIS PA-C

License Number: PA9105563

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9105563
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
08/09/2010
Address of Record
2650 WEST STATE RD. 434
EXPRESS CARE CLINIC
LONGWOOD, FL 32779
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
4161 14th Street North PRN PA's INC
SAINT PETERSBURG, FL 33703
Address
8130 Lakewood Main Street STE 103
LAKEWOOD RANCH, FL 34202
Name Relationship Profession License Effective Date
BANERJEE, PUSHPAL R Supervising Prescribing Practitioner Osteopathic Physician 8141 04/27/2017

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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.