License Verification

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ELIZA JANE CHEVALIER

License Number: PA9112106

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9112106
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
03/26/2019
Address of Record
701 W. PLYMOUTH AVENUE
DAYTONA BEACH, FL 32120-9430
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1055 Saxon Blvd
ORANGE CITY, FL 32763
Address
60 Memorial Medical Parkway
PALM COAST, FL 32164
Address
401 Palmetto St
NEW SMYRNA BEACH, FL 32168
Address
301 Memorial Medical Parkway
DAYTONA BEACH, FL 32117
Name Relationship Profession License Effective Date
LIVINGSTON, ROBERT TERENCE Supervising Prescribing Practitioner Medical Doctor 83159 05/01/2019
MCNAMEE, JUSTIN JAMES Supervising Prescribing Practitioner Osteopathic Physician 12888 04/08/2019
MOSES, DUSTY ALLEN DR Supervising Prescribing Practitioner Medical Doctor 115932 04/08/2019
MUCCIOLO, PAUL MD Supervising Prescribing Practitioner Medical Doctor 69281 04/08/2019
RAMIA, MICHELLE MARIE Supervising Prescribing Practitioner Medical Doctor 116871 04/08/2019
SISKO, MATTHEW DAVID Supervising Prescribing Practitioner Medical Doctor 111919 04/08/2019
WEINER, TRACY I DO Supervising Prescribing Practitioner Osteopathic Physician 7471 04/08/2019

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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.