License Verification

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OTTO RAUL MEDINILLA JR.

License Number: PA9106739

Data As Of 10/7/2025

Profession
Physician Assistant
License
PA9106739
License Status
Clear/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
08/23/2012
Address of Record
11300 LINDBERGH BLVD.
SUITE 115
THE LASER LOUNGE SPA
FORT MYERS, FL 33913
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
5100 Tamiami Trail N. Suite 104
NAPLES, FL 34103
Name Relationship Profession License Effective Date
GREENE, TUCKER MD Supervising Prescribing Practitioner Medical Doctor 76719 08/20/2025

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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 10/7/2025



* 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.