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SHELLEY SMITH TICKETT

License Number: ME90313

Data As Of 12/22/2024

Profession
Medical Doctor
License
ME90313
License Status
CLEAR/Active
License Expiration Date
1/31/2026
License Original Issue Date
05/12/2004
Address of Record
Lakeland Regional Hospital
1324 Lakeland Hills Blvd
LAKELAND, FL 33805
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
ALDEEN, AMER Z Supervisor Medical Doctor 134734 07/01/2017
ARENDS, DREW WILLIAM Supervisor Osteopathic Physician 16069 07/15/2019
BARQUIN, JOSE MIGUEL JR Supervisor Medical Doctor 131689 07/01/2017
BENIONI, TEARIKIRANGI ELIJAH Supervisor Medical Doctor 106942 10/01/2016
BUCHANAN, CURTIS BLAKE Supervisor Medical Doctor 131632 07/17/2017
CHRISTEN, AUSTEN MICHAEL Supervisor Medical Doctor 136668 08/01/2018
PALIGA, ANDREW Supervising Prescribing Practitioner Medical Doctor 111562 03/01/2019
PALIGA, ANDREW Supervisor Medical Doctor 111562 03/01/2019
PATEL, TEJAS Supervising Prescribing Practitioner Osteopathic Physician 13790 03/01/2019
PATEL, TEJAS Supervisor Osteopathic Physician 13790 03/01/2019
RODRIGUEZ, ZUHEILY CHRISTINE Supervising Prescribing Practitioner Medical Doctor 124014 03/01/2019
RODRIGUEZ, ZUHEILY CHRISTINE Supervisor Medical Doctor 124014 03/01/2019
SPENCER, ANDREW JOSEPH Supervising Prescribing Practitioner Medical Doctor 122767 05/06/2019
SPENCER, ANDREW JOSEPH Supervisor Medical Doctor 122767 03/01/2019

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

Name Relationship Profession License Effective Date
BABBS, GARRETT ADAM Prescribing Physician Assistant Physician Assistant 9108798 3/2/2017
BACH, MADELINE Prescribing Physician Assistant Physician Assistant 9109682 6/28/2017
BAILEY-STULTZ, MAROLDA P Prescribing Physician Assistant Physician Assistant 2031 2/21/2018
BLANKENSHIP, COURTNEY ANN Prescribing Physician Assistant Physician Assistant 9106490 2/21/2018
BRUNO, MARCUS Prescribing Physician Assistant Physician Assistant 9110320 2/20/2018
BUTZ, MELISSA A Prescribing Physician Assistant Physician Assistant 9102275 2/28/2018
CARDWELL, DONALD VINCENT JR Prescribing Physician Assistant Physician Assistant 3619 2/16/2018
COBB WEYAND, ALYSSA CLAIRE Prescribing Physician Assistant Physician Assistant 9109483 2/16/2018
CORINTH, TASHA Prescribing Physician Assistant Physician Assistant 9110450 1/5/2018
DAILEY, CHRISTY A Prescribing Physician Assistant Physician Assistant 9103849 11/21/2016
DELCAMP, CHRISTY LASSITER Prescribing Physician Assistant Physician Assistant 9105893 2/28/2018
DUONG-STRICKLAND, DIEN K Prescribing Physician Assistant Physician Assistant 3211 2/21/2018
EVERSOLE, KRISTEN SUSSANNE Prescribing Physician Assistant Physician Assistant 9103496 2/12/2018
HANSON, JULIE KIET Prescribing Physician Assistant Physician Assistant 9105034 2/21/2018
HOARD, MICHAEL RYAN Prescribing Physician Assistant Physician Assistant 9112164 12/5/2019
HODES, JAMIE LEE Prescribing Physician Assistant Physician Assistant 9109515 11/16/2016
JOHNSON, JILLIAN PALMER Prescribing Physician Assistant Physician Assistant 9105057 2/26/2018
KNOTEN, LAUREN Prescribing Physician Assistant Physician Assistant 9110039 1/3/2017
LAM, BETHANY-BINH KIET Prescribing Physician Assistant Physician Assistant 9103894 2/20/2018
LEVINE, REBECCA NICOLE Prescribing Physician Assistant Physician Assistant 9112012 11/12/2019
LYNCH, KATIE Prescribing Physician Assistant Physician Assistant 9110528 3/7/2018
MARTIN, SAMANTHA LEIGH Prescribing Physician Assistant Physician Assistant 9113333 10/1/2020
MAYNARD, TIMOTHY RONALD Prescribing Physician Assistant Physician Assistant 9108404 10/18/2017
MCCABE, JANET FAITH Prescribing Physician Assistant Physician Assistant 9104602 2/21/2018
MOODY, NANCY C Prescribing Physician Assistant Physician Assistant 2377 2/20/2018
MOORE, ERIN RACHEL Prescribing Physician Assistant Physician Assistant 9111310 12/6/2018
O'SHELL, COLLEEN MARIE Prescribing Physician Assistant Physician Assistant 9109521 8/5/2016
PALMER, BRIAN S Prescribing Physician Assistant Physician Assistant 1779 2/21/2018
PUTNAM, MALLORY MOODY Prescribing Physician Assistant Physician Assistant 9106745 2/21/2017
SELLERS JR, JAMES H Prescribing Physician Assistant Physician Assistant 9104288 3/27/2018
SOTO, STEFANIE Prescribing Physician Assistant Physician Assistant 9109569 9/26/2018
SUSSMAN, MICHAEL LORNE Prescribing Physician Assistant Physician Assistant 9107280 12/30/2015
THOMAS, JAMIE LEIGH Prescribing Physician Assistant Physician Assistant 9111031 12/10/2018
WALLACE, NICOLE ELIZABETH Prescribing Physician Assistant Physician Assistant 9103316 3/2/2018
WALLACE, STEVEN GREGORY JR Prescribing Physician Assistant Physician Assistant 9107761 2/28/2018
WILSON, KRISTOPHER DILLON Prescribing Physician Assistant Physician Assistant 9112568 10/1/2020

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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 12/22/2024



* 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.