License Verification

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DMITRIY BORISOVICH MODEL

License Number: ME88320

Data As Of 12/23/2024

Profession
Medical Doctor
License
ME88320
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2025
License Original Issue Date
07/30/2003
Address of Record
1633 RACETRACK ROAD 101
SUITE 101
AVECINA MEDICAL
JACKSONVILLE, FL 32259
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Yes
Discipline on File
No
Public Complaint
No
Address
9850 APPLECROSS ROAD 106 SUITE 106
JACKSONVILLE, FL 32222
Address
5915 Normandy bld
JACKSONVILLE, FL 32205
Address
1811 Blanding Bld 101
MIDDLEBURG, FL 32068
Address
2020 Kingsley Ave 1A
ORANGE PARK, FL 32073
Address
3600 SW Archer RD A-1
ORANGE PARK, FL 32608
Address
4160 Southside Bld 10
JACKSONVILLE, FL 32216
Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date
CLARK, SARAH Dispensing Physician Assistant Physician Assistant 9116056 12/1/2022
CLARK, SARAH Prescribing Physician Assistant Physician Assistant 9116056 12/1/2022
CLAYTON, DANA RENEE Dispensing Physician Assistant Physician Assistant 9112109 10/5/2023
DONALDSON, MAEVE MCCLAM Dispensing Physician Assistant Physician Assistant 9108018 8/1/2024
DONALDSON, MAEVE MCCLAM Prescribing Physician Assistant Physician Assistant 9108018 8/1/2024
FIFER, NICOLE ELAINE Prescribing Physician Assistant Physician Assistant 9108411 4/22/2016
HARRIS, FRANCESCA Prescribing Physician Assistant Physician Assistant 9116092 10/28/2022
JACKSON, COURTNEY CARSON Dispensing Physician Assistant Physician Assistant 9116193 10/11/2022
JEAN, MELCHISEDEK Dispensing Physician Assistant Physician Assistant 9115291 2/14/2022
JEAN, MELCHISEDEK Prescribing Physician Assistant Physician Assistant 9115291 2/14/2022
MCCARTHY, ELAINE MARY Dispensing Physician Assistant Physician Assistant 9115601 10/28/2024
MCCARTHY, ELAINE MARY Prescribing Physician Assistant Physician Assistant 9115601 10/28/2024
MUSTA-KINA, SONILA Dispensing Physician Assistant Physician Assistant 9109193 12/28/2018
MUSTA-KINA, SONILA Prescribing Physician Assistant Physician Assistant 9109193 12/28/2018
SCHROEDER, REGINA MARIE Prescribing Physician Assistant Physician Assistant 9118245 6/12/2024
SIZEMORE, SULE Prescribing Physician Assistant Physician Assistant 9110643 4/25/2022
WIERINGA, KIMBERLY MATTSON Prescribing Physician Assistant Physician Assistant 9105525 5/31/2017

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner



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.