License Verification

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CASSANDRA KLEBOUS SHRIVER

License Number: PA9110739

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9110739
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/25/2017
Address of Record
13535 NEMOURS PKWY
ORLANDO, FL 32827
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
3300 W. LAKE MARY BLVD SUITE 100 NEMOURS SPECIALITY CARE
LAKE MARY, FL 32746
Address
1717 S. ORANGE AVE SUITE 100 NEMOURS CHILDRENS CLINIC
ORLANDO, FL 32806
Address
1270 N. WICKHAM ROAD NEMOURS CHILDRENS CLINIC- MELBOURNE
MELBOURNE, FL 32935
Address
9368 NARCOOSSEE ROAD SUITE #105 NEMOURS CHILDRENS CLINIC, LAKE NONA
ORLANDO, FL 32827
Name Relationship Profession License Effective Date
BALDWIN, MARGARET ANN Supervising Prescribing Practitioner Medical Doctor 146064 06/21/2023
ILGENFRITZ, RYAN MATTHEW Supervising Prescribing Practitioner Medical Doctor 119700 12/11/2017
KHOURY, JOSEPH G Supervising Prescribing Practitioner Medical Doctor 130124 06/11/2023
LOVEJOY, JOHN FLETCHER III Supervising Prescribing Practitioner Medical Doctor 119262 07/12/2018
MALONE, JASON BRADLEY Supervising Prescribing Practitioner Osteopathic Physician 14628 07/12/2018
ROBINSON, LAWRENCE GEORGE Supervising Prescribing Practitioner Medical Doctor 57471 07/12/2018
STALL, ALEC CHRISTIAN Supervising Prescribing Practitioner Medical Doctor 136094 06/21/2023
STANTON, ROBERT PAGE Supervising Prescribing Practitioner Medical Doctor 34503 07/12/2018
STINSON, ZACHARY SULLIVAN Supervising Prescribing Practitioner Medical Doctor 134381 07/12/2018

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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 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.