License Verification

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KARA KOBYLKA RUSSELL

License Number: PA9105628

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9105628
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
09/03/2010
Address of Record
60 Columbia Street
4th Floor
ORLANDO, FL 32806
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
392 Rinehart Road Suite 3000
LAKE MARY, FL 32746
Address
7243 Della Drive
ORLANDO, FL 32819
Address
1700 Porter Road Suite 205
WINTER GARDEN, FL 34787
Name Relationship Profession License Effective Date
AVILUCEA, FRANK ROMAN Supervising Prescribing Practitioner Medical Doctor 135022 04/08/2020
HAIDUKEWYCH, GEORGE JOHN M D Supervising Prescribing Practitioner Medical Doctor 75428 04/15/2020
KUPISZEWSKI, STANLEY JOSEPH Supervising Prescribing Practitioner Medical Doctor 66643 04/08/2020
LANGFORD, JOSHUA ROBERT Supervising Prescribing Practitioner Medical Doctor 97765 01/01/2024
LEWELLYN, BRETT JAMES Supervising Prescribing Practitioner Medical Doctor 107935 04/07/2020
MUNRO, MARK WILLIAM Supervising Prescribing Practitioner Medical Doctor 87118 04/07/2020
PETRIE, JEFFREY RYAN Supervising Prescribing Practitioner Medical Doctor 127696 04/15/2020
SERVICE, BENJAMIN CHARLES Supervising Prescribing Practitioner Medical Doctor 124973 04/16/2020
SHAATH, MOHAMED KAREEM Supervising Prescribing Practitioner Medical Doctor 140615 04/02/2020
ZUMSTEG, JUSTIN WILLIAM Supervising Prescribing Practitioner Medical Doctor 127338 04/02/2020

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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



* 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.