License Verification

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KRISTEN LEIGH HERISTCHI

License Number: PA9102107

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9102107
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
08/28/2002
Address of Record
2340 Commerce Point Drive
Meadowbrook Centre/TriCounty
LAKELAND, FL 33801
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
BOLONA, LEOPOLD J Supervising Prescribing Practitioner Medical Doctor 138607 10/21/2019
CAMPBELL, ERICA ESTEP DO Supervising Prescribing Practitioner Osteopathic Physician 17890 11/15/2023
GELDART, DONALD BLAIR Supervising Prescribing Practitioner Medical Doctor 27412 12/04/2019
LATT, KHIN MAUNG Supervising Prescribing Practitioner Medical Doctor 88473 06/15/2017
NEGRON MUNOZ, ROSA ENIS MD Supervising Prescribing Practitioner Medical Doctor 111271 10/21/2019

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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.