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WILLIAM SHAW CARLSON

License Number: ME121446

Data As Of 12/2/2024

Profession
Medical Doctor
License
ME121446
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
08/28/2014
Address of Record
25 Teal Ct
SANTA ROSA BEACH, FL 32459
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
39 Logan Lane Unit 8
SANTA ROSA BEACH, FL 32459
Name Relationship Profession License Effective Date
CUPO, WILLIAM WALTER MD Supervising Prescribing Practitioner Medical Doctor 86389 09/14/2022
EDLER, RAYME MICHELLE Supervising Prescribing Practitioner Medical Doctor 109913 09/09/2021
MCNEIL, MEGAN IONE Supervising Prescribing Practitioner Medical Doctor 129689 05/02/2021
MCNEIL, MEGAN IONE Supervisor Medical Doctor 129689 07/22/2020
MULLIS, BARON THAXTON Supervising Prescribing Practitioner Medical Doctor 113789 02/02/2021
OWEN, STEPHANIE LEANN Supervisor Medical Doctor 127333 07/22/2020
SCHANDER, ARTUR Supervisor Osteopathic Physician 15691 07/22/2020

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Name Relationship Profession License Effective Date
AMBROSE, JESSICA Prescribing Physician Assistant Physician Assistant 9110160 2/21/2017
ATHEARN, CHERYL PARKER Prescribing Physician Assistant Physician Assistant 9107831 9/24/2018
BERRY, RANAE SHANNON Prescribing Physician Assistant Physician Assistant 9103545 1/8/2020
BUCK, JENNIFER FRANCES Prescribing Physician Assistant Physician Assistant 9106346 1/8/2020
CARRICO, KIERSTEN RENE Prescribing Physician Assistant Physician Assistant 9118188 1/5/2024
CRAWFORD, JIMMIE CONRAD Prescribing Physician Assistant Physician Assistant 9104289 9/23/2016
FOWLER JR, TIMOTHY DALE Prescribing Physician Assistant Physician Assistant 9110560 2/7/2018
GILLEY, PAMELA SCHNELL Prescribing Physician Assistant Physician Assistant 9104778 6/27/2017
KEETON, PATRICK RAY Prescribing Physician Assistant Physician Assistant 9107121 2/7/2019
MILLER, EMILY CAROLINE Prescribing Physician Assistant Physician Assistant 9118305 2/12/2024
SELLERS, SAMANTHA SUE Prescribing Physician Assistant Physician Assistant 9115984 10/20/2022
WANG, YU XING Prescribing Physician Assistant Physician Assistant 9109492 1/4/2024
WILKERSON, BENNY RAY JR Prescribing Physician Assistant Physician Assistant 9102065 10/28/2016

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/2/2024



* 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.