License Verification

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IAN JAMES JOHNSON

License Number: PA9110730

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9110730
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/22/2017
Address of Record
110 Longwood Ave
ROCKLEDGE, FL 32955
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
250 N Wickham Rd
MELBOURNE, FL 32935
Name Relationship Profession License Effective Date
ABD EL AZIZ, AHMED ESSAM Supervising Prescribing Practitioner Medical Doctor 168022 06/30/2024
ALAKIJA, CHARLES OBAFEMI Supervising Prescribing Practitioner Medical Doctor 80775 08/10/2022
ARIAS, ERICH ALBERTO Supervising Prescribing Practitioner Medical Doctor 101986 12/26/2023
ARMISTEAD, SHANNON ASHLEY Supervising Prescribing Practitioner Osteopathic Physician 17110 02/02/2023
ARNOLD, JOHN L JR Supervising Prescribing Practitioner Medical Doctor 90636 08/02/2021
BALLARD, PATRICK Supervising Prescribing Practitioner Osteopathic Physician 20852 06/12/2024
BANERJEE, PUSHPAL R Supervising Prescribing Practitioner Osteopathic Physician 8141 02/02/2023
BARABAS, ALEXANDRU Supervising Prescribing Practitioner Medical Doctor 133657 08/01/2021
BEATTY, ROBERT PATRICK Supervising Prescribing Practitioner Medical Doctor 97579 08/13/2021
BENSON, RACHEL Supervising Prescribing Practitioner Medical Doctor 169504 07/31/2024
BOYER, MICHAEL ANTHONY Supervising Prescribing Practitioner Osteopathic Physician 7483 10/12/2023
BRADEN, JOHN EMORY MD Supervising Prescribing Practitioner Medical Doctor 67031 08/01/2024
BRYAN, JENNIFER ANN ADAMS M D Supervising Prescribing Practitioner Medical Doctor 94013 07/01/2021
BUSTAMANTE, CHRISTIAN EDGAR M D Supervising Prescribing Practitioner Medical Doctor 145628 12/15/2023
CONNOLLY, PATRICK J Supervising Prescribing Practitioner Osteopathic Physician 19382 03/29/2023
DAVIDSON-JOCKOVICH, DAWN MARIE MD Supervising Prescribing Practitioner Medical Doctor 66378 08/02/2021
FERNANDEZ, JOHN RUSSELL Supervising Prescribing Practitioner Medical Doctor 65400 08/02/2021
FORD, ROBERT CHARLES III Supervising Prescribing Practitioner Osteopathic Physician 12456 07/02/2023
FREELS, KEVIN Supervising Prescribing Practitioner Medical Doctor 131199 07/01/2021
GLAZER, KELLY SYLVIA Supervising Prescribing Practitioner Medical Doctor 149363 08/13/2021
GRAHAM, KELLY ANN Supervising Prescribing Practitioner Physician Assistant 9112573 07/24/2021
HARBOUR, DAVID MARK Supervising Prescribing Practitioner Osteopathic Physician 8124 07/01/2021
HARRIS, PATRICK JENNINGS DO Supervising Prescribing Practitioner Osteopathic Physician 8101 07/15/2021
HEMINGWAY, THOMAS JARED Supervising Prescribing Practitioner Medical Doctor 153423 03/01/2023
HESSION, RORY ORLANT Supervising Prescribing Practitioner Medical Doctor 87577 08/01/2021
HILL, DUSTIN NICOLAS Supervising Prescribing Practitioner Medical Doctor 137031 07/24/2021
HOLCOMBE, KEVIN WESTRAY Supervising Prescribing Practitioner Medical Doctor 112246 08/15/2023
KAPPER, JORDAN Supervising Prescribing Practitioner Medical Doctor 159916 02/17/2023
LARICE, WALESKA Supervising Prescribing Practitioner Medical Doctor 117446 08/02/2024
LIN, EDWARD C Supervising Prescribing Practitioner Osteopathic Physician 11547 07/01/2021
MADSEN, ERIK ARTHUR Supervising Prescribing Practitioner Medical Doctor 163200 12/01/2023
MALLORY, GEORGE EDWARD D O Supervising Prescribing Practitioner Osteopathic Physician 5771 02/02/2023
MASIH, RAVI BAKHSHISH Supervising Prescribing Practitioner Medical Doctor 75539 08/03/2021
MAYOR-DAVIES, JUDY ANN Supervising Prescribing Practitioner Medical Doctor 73801 08/03/2021
MCINTYRE, MOLLY LAUREN Supervising Prescribing Practitioner Medical Doctor 116923 11/08/2023
MELLO, PAUL M Supervising Prescribing Practitioner Medical Doctor 142742 11/23/2022
MELONI, MICHAEL ANTHONY JR Supervising Prescribing Practitioner Medical Doctor 30755 08/01/2021
MITCHELL, CRAIG ROBERT MD Supervising Prescribing Practitioner Medical Doctor 102920 08/03/2021
MITCHELL, WILLIAM CLAY III Supervising Prescribing Practitioner Medical Doctor 129135 07/01/2021
NUNEZ-CUBILLAS, ALBERTO Supervising Prescribing Practitioner Physician Assistant 9101680 08/01/2021
PATEL, CHETAN R Supervising Prescribing Practitioner Medical Doctor 143328 07/01/2021
PATEL, SUMIT SUNIL Supervising Prescribing Practitioner Medical Doctor 135844 07/01/2021
PIRVAN, DANIEL FLAVIUS Supervising Prescribing Practitioner Medical Doctor 137055 07/01/2021
PITTS, DAPHNE MARIAN MD Supervising Prescribing Practitioner Medical Doctor 90371 10/09/2024
ROTONDO, JOHN ANTHONY Supervising Prescribing Practitioner Medical Doctor 149211 02/02/2023
SAVANI, PARESH D MD Supervising Prescribing Practitioner Medical Doctor 95295 07/01/2021
SHORAKA, CAMERON Supervising Prescribing Practitioner Medical Doctor 147021 08/03/2022
SZETO, LIAN Supervising Prescribing Practitioner Physician Assistant 9108169 08/03/2021
TANA, CHRISTOPHER FRANK Supervising Prescribing Practitioner Osteopathic Physician 10435 06/13/2023
TERWILLIGER, ZACHARY Supervising Prescribing Practitioner Medical Doctor 138339 03/14/2024
THOMAS, SANDI LYNN Supervising Prescribing Practitioner Osteopathic Physician 9258 02/02/2023
VELASCO, RODRIGO ERNESTO Supervising Prescribing Practitioner Medical Doctor 136030 08/03/2021
WARD, FREDERICK CHRISTOPHER M D Supervising Prescribing Practitioner Medical Doctor 85924 08/01/2021
WEAVER, LEAH DARE Supervising Prescribing Practitioner Physician Assistant 9103804 08/01/2021
WILKINSON, JOHN J Supervising Prescribing Practitioner Medical Doctor 131732 10/02/2024
WILSON, HOLLY JO Supervising Prescribing Practitioner Medical Doctor 98782 10/02/2024

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Name Relationship Profession License Effective Date
ABRAHAM, VARKEY Prescribing Physician Assistant Physician Assistant 3670 10/11/2021
APPEL, RACHEL Prescribing Physician Assistant Physician Assistant 9102351 10/11/2021
DENIZARD, REGINALD Prescribing Physician Assistant Physician Assistant 3579 10/11/2021
RUOCCO, DEBRALEE ANNE Prescribing Physician Assistant Physician Assistant 9102726 10/11/2021

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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.