License Number: DN14745Data As Of 11/24/2020
|License Expiration Date||2/28/2022|
|License Original Issue Date||01/09/1998|
|Address of Record||385 DOUGLAS AVE|
|ALTAMONTE SPRINGS, FL 32714|
|Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)||No|
|Discipline on File||No|
The information on this page is a secure, primary source for license verification provided by the Florida Department of Health, Division of Medical Quality Assurance. This website is maintained by Division staff and is updated immediately upon a change to our licensing and enforcement database.