License Verification

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JENNIFER LYNN LECKY

License Number: PA9106557

Data As Of 6/22/2024

Profession
Physician Assistant
License
PA9106557
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
04/24/2012
Address of Record
10920 McKinley Drive
TAMPA, FL 33612
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
12902 Magnolia Drive
TAMPA, FL 33612
Name Relationship Profession License Effective Date
CZERNIECKI, BRIAN JOSEPH Supervising Prescribing Practitioner Medical Doctor 129379 02/20/2020
HOOVER, SUSAN JANE MD Supervising Prescribing Practitioner Medical Doctor 91531 02/20/2020
KHAKPOUR, NAZANIN Supervising Prescribing Practitioner Medical Doctor 100313 02/20/2020
KILUK, JOHN VINCENT Supervising Prescribing Practitioner Medical Doctor 98964 02/20/2020
LARONGA, CHRISTINE Supervising Prescribing Practitioner Medical Doctor 93499 02/20/2020
LEE, MARIE CATHERINE Supervising Prescribing Practitioner Medical Doctor 99730 02/20/2020

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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 6/22/2024



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** 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.


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