License Verification

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MARJORIE KEMBLE DOUGHERTY

License Number: PA9101050

Data As Of 12/4/2024

Profession
Physician Assistant
License
PA9101050
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
08/11/1999
Address of Record
4500 SAN PABLO ROAD
MAYO CLINIC
JACKSONVILLE, FL 32224
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
GAMMARANO, CHRISTOPHER DAVID Supervising Prescribing Practitioner Medical Doctor 141579 06/03/2024
NGO, KENNETH TUYEN PHAM Supervising Prescribing Practitioner Medical Doctor 107208 05/03/2024

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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 12/4/2024



* 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.