License Verification

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THERESE E SULLIVAN

License Number: PA9105974

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9105974
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
04/21/2011
Address of Record
1530 Cornerstone Blvd
Suite 120
Empros
DAYTONA BEACH, FL 32117
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1055 SAXON BLVD. FLORIDA HOSPITAL FISH MEMORIAL
ORANGE CITY, FL 32763
Address
701 W. PLYMOUTH AVE. FLORIDA HOSPITAL DELAND
DELAND, FL 32720
Address
60 MEMORIAL MEDICAL PKWY FLORIDA HOSPITAL FLAGER
PALM COAST, FL 32164
Address
401 PALMETTO ST. FLORIDA HOSPITAL NEW SMYRNA
NEW SMYRNA BEACH, FL 32168
Address
301 MEMORIAL MEDICAL PKWY FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER
DAYTONA BEACH, FL 32117
Address
264 SOUTH ATLANTIC AVE. FLORIDA HOSPITAL OCEANSIDE
ORMOND BEACH, FL 32176
Address
701 W Plymouth Advent Health Deland
DELAND, FL 32720
Address
401 Palmetto Street Advent Bert Fish
NEW SMYRNA BEACH, FL 32168
Address
1055 Sayon Blvd Advent Health Fish
ORANGE CITY, FL 32763
Address
3120 Howland Blvd Advent Health Blvd
DELTONA, FL 32725
Name Relationship Profession License Effective Date
RIGA, PETER J Supervising Prescribing Practitioner Osteopathic Physician 10944 09/30/2016
ROBERTS, JUDY JENNIFER DO Supervising Prescribing Practitioner Osteopathic Physician 9253 09/30/2016

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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.