License Verification

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License Number: OS19896

Data As Of 12/2/2024

Profession
Osteopathic Physician
License
OS19896
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
3/31/2026
License Original Issue Date
03/31/2023
Address of Record
655 West Eighth Street
JACKSONVILLE, FL 32209
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

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date
BIRMINGHAM, RICHARD ERVIN Prescribing Physician Assistant Physician Assistant 9113895 8/5/2024
EISMONT, TRACEY JEAN Prescribing Physician Assistant Physician Assistant 3182 8/5/2024
HESTER, ZACHARY Prescribing Physician Assistant Medical Doctor 141445 8/5/2024
HINSON, JACOB CODY Prescribing Physician Assistant Physician Assistant 9108842 8/15/2024
LAMBERT, CAITLYN Prescribing Physician Assistant Physician Assistant 9109920 8/5/2024
PEHLIVANOVIC, MIRNA Prescribing Physician Assistant Physician Assistant 9110562 8/2/2024
SHIRLEY, KALEENA LYNN Prescribing Physician Assistant Physician Assistant 9109143 8/5/2024

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner



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.