License Verification

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MASON HAROLD HICKS

License Number: PA9111053

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9111053
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
01/23/2018
Address of Record
5147 N 9th Avenue
Suite 103
PENSACOLA, FL 32504
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
ALLISS, SAMIR JOSE Supervising Prescribing Practitioner Osteopathic Physician 7247 05/09/2024
BLAIR, AMANDA Supervising Prescribing Practitioner Osteopathic Physician 16098 05/09/2024
BRANTLEY, MITCHELL DAVID Supervising Prescribing Practitioner Medical Doctor 87928 05/09/2024
CANDELARIA, NOELANI ARANGO Supervising Prescribing Practitioner Osteopathic Physician 17870 05/09/2024
DENNISON, CHARLTON PAIGE Supervising Prescribing Practitioner Medical Doctor 121535 05/09/2024
DOLISTER, MICHAEL JAN Supervising Prescribing Practitioner Medical Doctor 66315 05/09/2024
EDLER, RAYME MICHELLE Supervising Prescribing Practitioner Medical Doctor 109913 05/09/2024
ELROD, WALTER Supervising Prescribing Practitioner Medical Doctor 137229 05/09/2024
HOLCOMBE, BENJAMIN WILLIS Supervising Prescribing Practitioner Medical Doctor 112819 05/09/2024
JACKSON, CORINNE SOKOLIK Supervising Prescribing Practitioner Medical Doctor 116991 05/09/2024
KHAN, MUHAMMAD Supervising Prescribing Practitioner Osteopathic Physician 16991 05/09/2024
KLEIN, JEFFREY GEORGE Supervising Prescribing Practitioner Medical Doctor 143907 05/09/2024
LUTHIN, WILLIAM NOLAN Supervising Prescribing Practitioner Medical Doctor 122535 05/09/2024
MAUREAU, MICHELLE MARIE DO Supervising Prescribing Practitioner Osteopathic Physician 9862 05/09/2024
MCINTOSH, NATHAN PHILIP Supervising Prescribing Practitioner Medical Doctor 159274 05/09/2024
MUNCY, TYLAN ANDREW Supervising Prescribing Practitioner Medical Doctor 147733 05/09/2024
NABERS, GREGORY WAYNE Supervising Prescribing Practitioner Medical Doctor 122995 05/09/2024
OWENBY, LAUREN Supervising Prescribing Practitioner Osteopathic Physician 12963 05/09/2024
PATRONI, CLYDE JOSEPH JR Supervising Prescribing Practitioner Medical Doctor 100780 05/09/2024
PRICE, CHRISTOPHER WAYNE Supervising Prescribing Practitioner Osteopathic Physician 17607 05/09/2024
RILEY, SCOTT IVAN Supervising Prescribing Practitioner Medical Doctor 101153 05/09/2024
SHOCKLEY, JAMES MARK Supervising Prescribing Practitioner Medical Doctor 140457 05/09/2024
STODARD, CHRISTOPHER MICHAEL Supervising Prescribing Practitioner Medical Doctor 119239 05/09/2024
TRUJILLO, DEBORAH JOY Supervising Prescribing Practitioner Medical Doctor 146744 05/09/2024
WELLS, BRANDEN LAMAUND Supervising Prescribing Practitioner Medical Doctor 82540 05/09/2024

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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.