License Verification

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STEPHANIE MARIE SHOULTS

License Number: PA9111528

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9111528
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/05/2018
Address of Record
4853 big island drive
JACKSONVILLE, FL 32246
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
115 professional drive Unit 101
PONTE VEDRA BEACH , FL 32082
Name Relationship Profession License Effective Date
ASHBAUGH, HEIDI HANSEN Supervising Prescribing Practitioner Medical Doctor 114866 09/21/2018
GUTIERREZ, FRANCISCO JAVIER Supervising Prescribing Practitioner Osteopathic Physician 10432 09/27/2018

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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.