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CAROL PHYLLIS VAN PUTTEN

License Number: AA253

Data As Of 12/4/2024

Profession
Anesthesiologist Assistant
License
AA253
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
01/15/2015
Address of Record
1525 W Cypress Creek Rd
APT #A
FORT LAUDERDALE, FL 33309
Discipline on File
No
Public Complaint
No
Address
2482 LAURELWOOD COURT
TALLAHASSEE, FL 32308
Name Relationship Profession License Effective Date
APPLEGATE, MARK RICHARD Supervising ME Medical Doctor 96955 03/11/2015
ATWATER, ROBERT JACKSON Supervising ME Medical Doctor 72543 03/11/2015
BAKER, WILMOTH HENRY III Supervising ME Medical Doctor 56076 03/11/2015
BHIMANI, VIPUL V Supervising ME Medical Doctor 120292 03/11/2015
CANNELLA, MARK E Supervising ME Medical Doctor 95603 03/11/2015
CONRAD, DANIEL PAUL MD Supervising ME Medical Doctor 34908 03/11/2015
DIAZ, JESUS Supervising ME Medical Doctor 116567 03/11/2015
DRAPER, DAVID WINTHROP MD Supervising ME Medical Doctor 67772 03/11/2015
DRAPER, KEVIN WINTHROP Supervising ME Medical Doctor 144509 04/24/2024
DUNKERLEY, CHRISTOPHER JOHN Supervising ME Medical Doctor 147307 04/24/2024
FRANKLAND, JAMES MICHAEL Supervising ME Medical Doctor 82386 03/11/2015
GILLELAND, SCOTT BENJAMIN Supervising ME Medical Doctor 139878 04/24/2024
GIRALT, JOAKIM ANTHONY MD Supervising ME Medical Doctor 60659 03/11/2015
GREEN, JOHN C M D Supervising ME Medical Doctor 128019 04/24/2024
HENRY, RICHARD L Supervising ME Medical Doctor 46736 03/11/2015
HORTON, ELIZABETH MAY Supervising ME Medical Doctor 120303 03/11/2015
JAIN, PRAVIN KUMAR Supervising ME Medical Doctor 158406 04/24/2024
LAZZELL, VALERIE ANNE Supervising ME Medical Doctor 64805 03/11/2015
LOEFFLER, NANCY L MD Supervising ME Medical Doctor 66089 03/11/2015
LUIBRAND, NATHAN Supervising ME Medical Doctor 166293 11/06/2024
LYNCH, PATRICK Supervising ME Osteopathic Physician 20536 11/06/2024
MAI, HARRY THANHHAO Supervising ME Medical Doctor 149964 04/24/2024
MARCHIO, WILLIAM ALAN Supervising ME Medical Doctor 110912 04/24/2024
MCLANAHAN, GREGORY ALLEN Supervising ME Medical Doctor 82354 03/11/2015
MILLER, MICHAEL WILLIAM CARL Supervising ME Medical Doctor 88327 03/11/2015
MNOOKIN, STEPHEN CHARLES Supervising ME Medical Doctor 82157 03/11/2015
MOORE, LATASHA DENISE Supervising ME Medical Doctor 129044 04/24/2024
MYERS, JEFFREY ALLEN MD Supervising ME Medical Doctor 70940 03/11/2015
O'NEILL, JAMES FRANCIS Supervising ME Medical Doctor 54677 03/11/2015
PADALIA, JITENDRA G Supervising ME Medical Doctor 34721 03/11/2015
SAND, ROBERT IAN SUPERVISOR for AA Osteopathic Physician 16962 04/24/2024
SCHWINDT, TIANI Supervising ME Medical Doctor 166663 11/06/2024
SELL, BRENCE ALAN Supervising ME Medical Doctor 53808 03/11/2015
STAPLETON, DAVID DION Supervising ME Medical Doctor 120024 03/11/2015
TAYLOR, LIBERTY EVE Supervising ME Medical Doctor 123779 04/24/2024
THURMAN, NANCY M Supervising ME Medical Doctor 133939 04/24/2024
TIAN, LING Supervising ME Medical Doctor 155905 04/24/2024
TOTTEN, JAMES ALBERT Supervising ME Medical Doctor 56833 03/11/2015
WALKER, JAMES DEAROE Supervising ME Medical Doctor 117278 04/24/2024
WARREN, SAMUEL MACKENZIE Supervising ME Medical Doctor 66560 03/11/2015
WENLEDER, BRETT CHRISTIAN Supervising ME Medical Doctor 109099 03/11/2015
WILHOIT, CHRISTOPHER ANDREW M D Supervising ME Medical Doctor 72642 03/11/2015

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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 12/4/2024



* 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.